不同频率重复经颅磁刺激治疗多系统萎缩的临床疗效研究OA

Objective To identify the effective therapeutic targets of multiple system atrophy-parkinsonian type(MSA-P)based on clinical and electrophysiological assessment indices,and to investigate the clinical efficacy of low-frequency versus high-frequency repetitive transcranial magnetic stimulation(rTMS)applied to the primary motor cortex(M1 region)of the brain in patients with MSA-P.Methods A total of 40 patients with MSA-P who were diagnosed and treated in Jilin People's Hospital from January 2023 to December 2024 were enrolled,and according to the frequency of rTMS,they were divided into low-frequency group with 20 patients and high-frequency group with 20 patients.The pa-tients in the low-frequency group received 1 Hz rTMS over the M1 region,while those in the high-frequency group received 5 Hz rTMS over the M1 region,and clinical and electrophysiological assessments were performed for both groups at 1 week,2 weeks,4 weeks,and 3 months after intervention.Results After low-frequency or high-frequency rTMS was applied to the M1 region of MSA-P patients,there were no significant improvements in clinical and electrophysiological as-sessment indices in the low-frequency group,while the high-frequency group had significant improvements in clinical and electrophysiological assessment indices.Conclusion The primary motor cortex(M1 region)of the brain is an effective therapeutic target for MSA-P.Excitatory stimulation of the M1 region significantly improves the clinical and electrophysi-ological assessment indices of MSA-P,while inhibitory stimulation of the M1 region fails to achieve such improvements.This study shows that rTMS is an effective therapeutic modality for MSA-P and thus holds promise for clinical application.High-frequency rTMS over the M1 region can improve the symptoms of MSA-P and correct abnormal rhythmic activity within the cortex and related subcortical brain regions,thereby achieving a sustained therapeutic effect.