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目的:采用低频重复经颅磁刺激(rTMS)对视觉空间忽略的患者进行治疗,通过行为学方法观察其治疗前后忽略的变化并探讨其脑机制。方法:14例脑血管意外后伴视觉空间忽略两周后无自然恢复的患者,分为治疗组和对照组各7例,治疗组采用rTMS进行治疗,刺激强度为运动阈值的90%,频率0.5Hz,刺激位点位于患者健侧大脑的顶叶后部(EEG10-20标准的P3点)。每次治疗15min,每天2次,连续治疗2周。并连续观察治疗两周后忽略的变化情况。结果:经过rTMS对左侧大脑的顶叶后部进行连续刺激两周后,患者的忽略明显改善。其中线段划消及直线二等分测试均表现为治疗前后有明显的差异。结论:使用rTMS后,患者的视觉空间忽略明显改善。经颅磁刺激治疗作为一种无创性的治疗方法,对视觉空间忽略有效。本结果支持注意网络的半球竞争理论。
OBJECTIVE: To treat patients with neglected visual space by low frequency repetitive transcranial magnetic stimulation (rTMS) and to observe their neglected changes before and after treatment by behavioral methods and to explore their brain mechanisms. Methods: Fourteen cases of cerebrovascular accident with visual space neglected spontaneous recovery after two weeks were divided into treatment group (n = 7) and control group (n = 7). The treatment group was treated with rTMS. The stimulation intensity was 90% of the exercise threshold and the frequency was 0.5 Hz at the posterior parietal lobe of the contralateral brain in patients (EEG10-20 standard P3). Each treatment 15min, 2 times a day, continuous treatment for 2 weeks. And continuous observation of two weeks after treatment ignored changes. Results: After two weeks of continuous stimulation of the posterior parietal lobe of the left brain via rTMS, patient neglect improved significantly. Line segment cancellation and linear bisection test showed significant differences before and after treatment. Conclusion: The patient’s visual spatial neglect was significantly improved after using rTMS. Transcranial magnetic stimulation is a noninvasive treatment that ignores visual space. This result supports attention to the network hemispheric competition theory.