Ignacio Pezoa-Peña, Teresa Julio-Ramos, Igor Cigarroa, Diana Martella, Daniel Solomons, David Toloza-Ramirez
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引用次数: 0
摘要
经颅磁刺激(TMS)被认为在中风后患者的神经康复中大有可为。失语症和认知障碍(CI)是脑卒中后的常见病,然而,人们对基于 TMS 的干预措施的特点及其神经心理和解剖功能方面的益处仍缺乏共识。因此,有必要开展研究,为这些神经系统疾病制定 TMS 方案。本研究旨在分析 TMS 对脑卒中后 CI 和失语患者的神经心理和解剖功能影响的证据,并确定研究实践中使用最多的 TMS 的特点。本研究遵循 PRISMA 指南,收录了 PubMed、Scopus、Web of Science、ScienceDirect 和 EMBASE 数据库中 2010 年 1 月至 2023 年 3 月间发表的文章。在所查阅的 15 篇文章中,我们发现注意力、记忆力、执行功能、语言理解能力、命名能力和语言流畅性(语义和语音)是经颅磁刺激后得到改善的神经心理学领域。此外,TMS 对失语症和中风后 CI 有助于增强额叶激活(额叶下回、三角旁和厣)。此外,还发现了颞顶叶效应。在以重复方式、1赫兹的频率、30分钟的疗程、持续两周以上的时间进行经颅磁刺激时,观察到的效果就会出现。使用 TMS 有助于脑卒中后 CI 和失语患者的神经康复过程。然而,未来仍有必要根据准确的 TMS 特征对干预方案进行标准化。
Neuropsychological and Anatomical-Functional Effects of Transcranial Magnetic Stimulation in Post-Stroke Patients with Cognitive Impairment and Aphasia: A Systematic Review.
Transcranial magnetic stimulation (TMS) has been found to be promising in the neurorehabilitation of post-stroke patients. Aphasia and cognitive impairment (CI) are prevalent post-stroke; however, there is still a lack of consensus about the characteristics of interventions based on TMS and its neuropsychological and anatomical-functional benefits. Therefore, studies that contribute to creating TMS protocols for these neurological conditions are necessary. To analyze the evidence of the neuropsychological and anatomical-functional TMS effects in post-stroke patients with CI and aphasia and determine the characteristics of the most used TMS in research practice. The present study followed the PRISMA guidelines and included articles from PubMed, Scopus, Web of Science, ScienceDirect, and EMBASE databases, published between January 2010 and March 2023. In the 15 articles reviewed, it was found that attention, memory, executive function, language comprehension, naming, and verbal fluency (semantic and phonological) are the neuropsychological domains that improved post-TMS. Moreover, TMS in aphasia and post-stroke CI contribute to greater frontal activation (in the inferior frontal gyrus, pars triangularis, and opercularis). Temporoparietal effects were also found. The observed effects occur when TMS is implemented in repetitive modality, at a frequency of 1 Hz, in sessions of 30 min, and that last more than 2 weeks in duration. The use of TMS contributes to the neurorehabilitation process in post-stroke patients with CI and aphasia. However, it is still necessary to standardize future intervention protocols based on accurate TMS characteristics.
期刊介绍:
Neuropsychology Review is a quarterly, refereed publication devoted to integrative review papers on substantive content areas in neuropsychology, with particular focus on populations with endogenous or acquired conditions affecting brain and function and on translational research providing a mechanistic understanding of clinical problems. Publication of new data is not the purview of the journal. Articles are written by international specialists in the field, discussing such complex issues as distinctive functional features of central nervous system disease and injury; challenges in early diagnosis; the impact of genes and environment on function; risk factors for functional impairment; treatment efficacy of neuropsychological rehabilitation; the role of neuroimaging, neuroelectrophysiology, and other neurometric modalities in explicating function; clinical trial design; neuropsychological function and its substrates characteristic of normal development and aging; and neuropsychological dysfunction and its substrates in neurological, psychiatric, and medical conditions. The journal''s broad perspective is supported by an outstanding, multidisciplinary editorial review board guided by the aim to provide students and professionals, clinicians and researchers with scholarly articles that critically and objectively summarize and synthesize the strengths and weaknesses in the literature and propose novel hypotheses, methods of analysis, and links to other fields.