TMS临床治疗分类汇总表.doc

Supplementary Table 1 Noninvasive brain stimulation and chronic pain.a ReferenceStimulation siteStimulation parametersStudy DesignNPain etiology Outcome measuresConclusionsLefaucheur et al. (2001)1M1 corresponding to the painful area10Hz, 1000 pulses, 80% MT, one sessionCrossover14Trigeminal neuralgia, thalamic strokeVisual analog scaleSignificant but transient reduction in painLefaucheur et al. (2001)2M1 corresponding to the painful area10Hz and 1Hz, 1000 pulses, 80% MT, one session Crossover18Thalamic stroke, brainstem lesion, brachial plexus lesionVisual analog scaleSignificant but transient reduction in pain only after 10 Hz rTMSCanavero et al. (2002)3M1 corresponding to the painful area0.2Hz, 20 pulses, 100% machine output, one sessionNot reportedb9Brain ischemia, spinal cord injury or syringomyeliaVisual analog scale, numerical rating scaleMixed results, 3/9 patients reported significant pain relief for not more than 16 hours. The rTMS pain relief was also strongly correlated with propofol-induced pain relief.Brighina et al. (2004)4Left dorsolateral prefrontal cortex20Hz, 400 pulses, 90% MT, 12 sessions, one every other day Parallel11Chronic migraineNumber of migraine attacks, number of ingested pills Significant long-term reduction in both number of headaches and amount of medicine ingested; effects lasted for at least 2 months after treatmentLefaucheur et al. (2004)5M1 corresponding to the painful area10Hz, 1000 pulses, 80% MT, one sessionCrossover60Thalamic stroke, brainstem lesion, brachial plexus lesion, spinal cord lesion, trigeminal nerve lesionVisual analog scaleSignificant but transient reduction in painPleger et al. (2004)6M1 hand area10Hz, 120 pulses, 110% MT, one sessionCrossover10Minor trauma, radial fracture, luxation of 2nd and 3rd fingers, fracture of navicular boneVisual analog scaleReduction in pain for 45 minutesKhedr et al. (2005)7M1 corresponding to the painful area20Hz, 2000 pulses, 80% MT, five consecutive daysParallel48Trigeminal neuralgia, poststrokeVisual analog scale, LANSSSignificant reduction in pain, up to 2 weeks post-stimulationFregni et al. (2005)8Right secondary somatosensory cortex1Hz, 1600 pulses, 90% MT, one session Crossover5Chronic pancreatitis (visceral pain)Visual analog scaleSignificant but transient reduction in painHirayama et al. (2006)9M1 corresponding to the painful area and somatosensory, premotor and supplementary area5Hz, 500 pulses, 90% MT, one sessionCrossover20Poststroke, spinal cord lesion, trigeminal neuropathy, brachial plexus injury, peripheral neuroma operation, cauda equina lesionVisual analog scale, McGill Pain QuestionnaireSignificant reduction in pain after M1 stimulation only, as compared with other areas of stimulationSampson et al. (2006)10Right dorsolateral prefrontal cortex1Hz, 1600 pulses, 110% MT, 5 times per week for 4 weeksSee belowc4FibromyalgiaVisual analog scale1527 week reduction in pain across all four subjectsAndre-Obadia et al. (2006)11M1 hand area (abductor digitiminimi)1 and 20 Hz, 1600 pulses, 90% MT, one session eachCrossover14Central supratentorial or brainstem poststroke pain, spinal cord injury, peripheral lesionVisual analog scale, subjective global assesment Pain improvement after 20 Hz and sham stimulation, but not after 1Hz stimulation. Only 20Hz stimulation predicted the efficacy of subsequent invasive motor cortex stimulationLefaucheur (2006)12M1 corresponding to the painful hand area10Hz and 1Hz, 1200 pulses, 90% MT, one sessionCrossover22Unilateral neuropathic pain (stroke, cervical spinal cord lesion, tumor, and brachial plexus/nerve trunk lesion)Visual analog scaleSignificant reduction in pain only after 10 Hz rTMSJohnson et al. (2006)13Left M1/S1 20Hz, 500 pulses, 95% MTCrossover17Chronic back painBrief Pain InventorySignificant reductions in pain in 13/17 patients who received active stimulation. The sham condition produced no significant change in pain rating.Fregni et al.(2006)14Left M1 (corresponding to C3) Anodal tDCSd 20 minutes, 2 mA, five consecutive daysParallel17Spinal cord injuryVisual analogue scale, CGI, PGA, medication useThere was a significant pain improvement after active anodal stimulation of the motor cortex, but not after sham stimulationFregni et al.(2006)15Left M1 (C3), left dorsolateral prefrontal cortex (F3)Anodal tDCSd, 20 minutes, 2mA, five consecutive daysParallel32FibromyalgiaVisual analogue scale, CGI, PGA, SF-36 Health Survey (Medical Outcomes Trust, Inc., Waltham, MA), FIQ, medication useAnodal tDCS of the primary motor cortex induced significantly greater pain improvement compared with sham stimulation and stimulation of the dorsolateral prefrontal cortex. This effect was still significant after 3 weeks of follow-up aAll studies in this table used figure-of-eight coils. Transcranial direct current stimulation studies are shaded in gray. bStudy design specifics, control conditions, as well as the blinds for the study were not reported. A crossover design is most likely. cPart of a double-blind sham-controlled trial for major depression and borderline disorder; only one patient received sham stimulation. dThe reference electrode was placed over the contralateral supraorbital area. Abbreviations: CGI, Clinical Global Impression; FIQ = Fibromyalgia Impact Questionnaire; LANSS, Leeds assessment of neuropathic symptoms and signs; M1, primary motor cortex; MT, motor threshold; N, number of patients; PGA, patient global assessment; rTMS, repetitive transcranial magnetic stimulation; S1, primary somatosensory cortex; tDCS; transcranial direct current stimulation References1. Lefaucheur JP et al. (2001) Interventional neurophysiology for pain control: duration of pain relief following repetitive transcranial magnetic stimulation of the motor cortex. Neurophysiol Clin 31: 2472522. Lefaucheur JP et al. (2001) Pain relief induced by repetitive transcranial magnetic stimulation of precentral cortex. Neuroreport 12: 296329653. Canavero S et al. (2002) Transcranial magnetic cortical stimulation relieves central pain. Stereotact Funct Neurosurg 78: 1921964. Brighina F et al. (2004) rTMS of the prefrontal cortex in the treatment of chronic migraine: a pilot study. J Neurol Sci 227: 67715. Lefaucheur JP et al. (2004) Improvement of motor performance and modulation of cortical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinsons disease. Clin Neurophysiol 115: 253025416. Pleger B et al. (2004) Repetitive transcranial magnetic stimulation of the motor cortex attenuates pain perception in complex regional pain syndrome type I. Neurosci Lett 356: 87907. Khedr EM et al. (2005) Longlasting antalgic effects of daily sessions of repetitive transcranial magnetic stimulation in central and peripheral neuropathic pain. J Neurol Neurosurg Psychiatry 76: 8338388. Fregni F et al. (2005) Treatment of chronic visceral pain with brain stimulation. Ann Neurol 58: 9719729. Hirayama A et al. (2006) Reduction of intractable deafferentation pain by navigation-guided repetitive transcranial magnetic stimulation of the primary motor cortex. Pain 122: 222710. Sampson SM et al. (2006) Slow-frequency rTMS reduces fibromyalgia pain. Pain Med 7: 11511811. Andre-Obadia N et al. (2006) Transcranial magnetic stimulation for pain control. Double-blind study of different frequencies against placebo, and correlation with motor cortex stimulation efficacy. Clin Neurophysiol 117: 1536154412. Lefaucheur JP (2006) Repetitive transcranial magnetic stimulation (rTMS): insights into the treatment of Parkinsons disease by cortical stimulation. Neurophysiol Clin 36: 12513313. Johnson S et al. (2006) Changes to somatosensory detection and pain thresholds following high frequency repetitive TMS of the motor cortex in individuals suffering from chronic pain. Pain 123: 18719214. Fregni F et al. (2006) A sham-controlled, phase II trial of transcranial direct current stimulation for the treatment of central pain in traumatic spinal cord injury. Pain 122: 19720915. Fregni F et al. (2006) A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. Arthritis Rheum 54: 39883998Supplementary Table 2 Noninvasive brain stimulation and stroke.aStudySite of stimulationStimulation parametersStudy designNStroke characteristicsOutcome measuresConclusions Mansur et al. (2005)1Contralesional M1 and premotor areas1 Hz, 600 pulses, 100% MT, one sessionCrossover10Small-vessel ischemic stroke, mild-moderate hemiparesis, subacute stroke; treatment given 6 months after strokePinch task (measuring force and acceleration)Increased acceleration on pinch task and decreased transcallosal inhibition for active rTMS group; effects lasted 3 months after stroke Motor skill learning task: accuracy, RT, MEP amplitudeActive rTMS transiently increased motor skill learning, accuracy and RT; long-term effects not studiedFregni et al. (2006)5Contralesional M1 (corresponding to FDI)1 Hz, 1200 pulses, 100% MT, five sessionsParallel15Single ischemic stroke, mild to moderate motor deficit; treatment given 1 year after stroke JTT, sRT, cRT, Perdue Pegboard TestSignificant improvement across various motor tests lasting 2 weeksFregni et al. (2005)6Contralesional M1 and ipsilesional M1Anodal tDCS (contralesional M1) and cathodal tDCS (ipsilesional tDCS), 1mA, 20 minutes, single session Crossover6Single ischemic stroke, mild to moderate motor deficit; treatment given 1 year after stroke JTTBoth cathodal stimulation of the unaffected hemisphere and anodal stimulation of the affected hemisphere (but not sham tDCS) improved motor performance significantlyHummel et al. (2005)7Contralesional M1Anodal tDCS, 1mA, 20 minutes, single session Crossover6Single ischemic stroke, mild motor deficit; treatment given 1 year after stroke JTTJTT measured in the paretic hand improved significantly in the active tDCS group compared with the sham group, and this improvement was correlated with an increment in motor cortical excitability within the affected hemisphereHummel et al. (2006)8Contralesional M1Anodal tDCS, 1mA, 20 minutes, single sessionCrossover11Single subcortical chronic ischemic stroke with severe motor deficit (MRC grade below 2)sRT (wrist flexion) and pinch force testingActive anodal tDCS applied to affected M1 resulted in transient improvements in motor function as indexed by maximal pinch force and RTs; these effects were more pronounced in patients with larger motor deficitsBoggio et al. (2007)9Contralesional M1 and ipsilesional M1Anodal tDCS (contralesional M1) and cathodal tDCS (ipsilesional tDCS), 1mA, 20 minutes, single sessionCrossoverb4Single ischemic stroke, mild to moderate motor deficit; treatment given 1 year after stroke JTTSignificant motor function improvement after either cathodal tDCS of the unaffected hemisphere or anodal tDCS of the affected hemisphere when compared with sham tDCSaTranscranial direct current studies are shaded in gray. bWe did not report the results of the consecutive sessions treatment of this study as this was collected as an open label data. For the tDCS studies, the reference electrode was placed in the contralateral supraorbital area. Abbreviations: ADM, abductor digiti minimi; BI, Barthel Index; cRT, choice reaction time; F8, figure-of-eight coil; FDI, first dorsal interosseous; JTT, JebsenTaylor Hand Function Test; M1, primary motor cortex; MEP, motor evoked potentials; MT, motor threshold Au: OK?; MRC, Medical Research Council; N, number of patients; MT, motor threshold; NIHSS, NIH Stroke Scale; RT, reaction time; rTMS, repetitive transcranial magnetic stimulation; sRT, simple reaction time; SSS, Scandinavian Stroke Scale; tDCS, transcranial direct current stimulation. References1. Mansur CG et al. (2005) A sham stimulation-controlled trial of rTMS of the unaffected hemisphere in stroke patients. Neurology 64: 180218042. Takeuchi N et al. (2005) Repetitive transcranial magnetic stimulation of contralesional primary motor cortex improves hand function after stroke. Stroke 36: 268126863. Khedr EM et al. (2005) Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke. Neurology 65: 4664684. Kim YH et al. (2006) Repetitive transcranial magnetic stimulation-induced corticomotor excitability and associated motor skill acquisition in chronic stroke. Stroke 37: 147114765. Fregni F et al. (2006) A sham-controlled trial of a 5-day course of repetitive transcranial magnetic stimulation of the unaffected hemisphere in stroke patients. Stroke 37: 211521226. Fregni F et al. (2005) Transcranial direct current stimulation of the unaffected hemisphere in stroke patients. Neuroreport 16: 155115557. Hummel F et al. (2005) Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain 128: 4904998. Hummel FC et al. (2006) Effects of brain polarization on reaction times and pinch force in chronic stroke. BMC Neurosci 7: 739. Boggio PS et al.: Repeated sessions of noninvasive brain DC stimulation is associated with motor function improvement in stroke patients. Restor Neurol Neurosci, in pressSupplementary Table 3 Noninvasive brain stimulation and Parkinsons disease.a ReferenceSite of stimulationStimulationparametersStudydesignNOnoffstatusOutcomemeasuresConclusionsSiebner et al. (1999)1M1 hand area contralateral to affected limb5 Hz, 1000 pulses, 90% MT, one sessionCrossover12Off statePointing RT and accuracyRT for pointing movements decreased transiently after active rTMS, accuracy not affectedGhabra et al. (1999)2M1 of the dominant hemisphere5 Hzb 8085% MT, one sessionCrossover11Off stateUPDRSNo significant effects as measured directly following stimulationSiebner et al. (2000)3M1 hand area contralateral to affected limb5 Hz, 2250 pulses, 90% MT, one sessionCrossover10Off stateUPDRSImprovement of UPDRS (bradykinesia, rigidity and tremor) 1 hr poststimulationBoylan et al.(2001)4 Supplementary motor area10 Hz, 2000 pulses, 110% MT, one sessionCrossover10Off stateUPDRS, RT/MT, spiral analysisTransient worsening of performance on spiral drawing task, increased RT 3045 minutes poststimulationShimamoto et al. (2001)5 Bilateral frontal lobes0.2 Hz, 30 pulses x 2, 700 V, once weekly over 2 monthsParallel18On stateADL, UPDRSSignificant long-term improvement on both ADL and UPDRS motor function, as assessed after 1 and 2 monthsSommer et al. (2002)6M1: ADM contralateral to dominant hand1 Hz, 900 pulses, 120% MT, one sessionCrossover11See belowcCURSTransient improvement of bradykinesia (as measured by finger tapping)Ikeguchi et al. (2003)7 Bilateral frontal lobes and occipital cortex0.2 Hz, 30 pulses x 2, 70% maximum output, one sessionPartial crossoverd12On stateADL,UPDRSSignificant ADL and UPDRS motor improvement 1 week after M1 rTMS Okabe et al. (2003)8 Bilateral M1 (FDI) and occipital cortex0.2 Hz, 100 pulses, 110% active MT, once weekly for 8 weeksParallel85See beloweUPDRSNo significant improvement of M1 rTMS as compared with occipital stimulation or sham over 16 week evaluationKhedr et al. (2003)9 M1 lower limb area and hand ADM5 Hz, 2000 pulses, 120% MT, once daily for 10 daysParallel36Off stateUPDRS, walking speed, self-assessment scaleSignificant long-term improvement in UPDRS score for the duration of at least 1 monthFregni et al. (2004)10Left DLPFC15 Hz, 3000 pulses 110% MT, once daily for 10 days in 2 weeksParallelf42On stateADL, UPDRSSmall improvement in motor function (indexed by ADL scores) after 8 weeks; no significant interaction effect; no significant change in UPDRSLefaucher et al. (2004)11 Left M1 corresponding to FDI0.5 Hz, 600 pulses; 10 Hz, 2000 pulses, 80% MT, one session eachCrossover12Off stateUPDRS, Purdue Pegboard Test, CAPSIT0.5 Hz stimulation improved UPDRS score (rigidity bilaterally) and walking; 10 Hz also improved UPDRS score (contralateral rigidity and bradykinesia ) 20 minutes poststimulationDias 200612 Left DLPFC15 Hz, 3000 pulses, 110% MT, 10 sessionsParallel30On stateMood (quality of life) and voice parametersLDPFC stimulation significantly improved mood but did not improve voice parameters (intensity and fundamental frequency)Lomarev 200613 Left and right M1, left and right DLPFC25 Hz, 300 pulses, 100% MT to M1, eight sessions over 4 weeksgParallel18On stateUPDRS, walking test, complex hand taskSignificant decrease in RT for executi