Effect of different frequency repetitive transcranial magnetic stimulation on dysarthria in patients with Parkinson's dis-ease
Objective:To observe the therapeutic effect of different frequency repetitive transcranial magnetic stim-ulation(rTMS)combined with articulation training on dysarthria in patients with Parkinson's disease(PD).Meth-od:A total of 64 patients with PD articulation disorders were randomly divided into a control group,a high-frequen-cy group,a low-frequency group,and a sham stimulation group,with 16 cases in each group.The control group re-ceived 40 min of articulation training.The high-frequency group was treated with 5 Hz rTMS stimulation of the both of primary sensory motor area(OF-SM1)on both sides of the mouth and face for 20 min combined with articulation training for 40 min on the basis of the conventional group.The low-frequency group received 1Hz rTMS stimulation of the OF-SM1 area on both sides for 20 min combined with articulation training for 40 min on the basis of the con-ventional group.The sham stimulation group received rTMS stimulation of the OF-SM1 area on both sides(without magnetic field output)for 20 min combined with articulation training for 40 min on the basis of the conventional group,once a day,for a total of 30 days of treatment.Before treatment,immediately after treatment(30 days after treatment),and during follow-up(30 days after treatment),the frenchay dysarthria rating scale,hoarseness rat-ing scale(GRBAS),The voice handicap index(VHI),The communication effectiveness index(CETI)scale,amplitude standard deviation,continuous speech ability speech rate,speech fundamental frequency standard de-viation(F0SD),maximum phonation time(MPT),maximum counting ability(cMCA),contact quotient perturbation(CQP),normalized noise energy(NNE),second formant(F2/i/)and average intensity assessment were used to compare the therapeutic differences in articu-latory organ motor function,voice hoarseness degree and self-subjective perception,verbal communication ability,speech rhythm,speech speed,intonation,respiratory support,respiration and vocal coordination,glottic closure regularity,breath sound,oral resonance,and volume among 4 groups.Results:Compared to those before treat-ment,frenchay scores,amplitude standard deviation,mean intensity,F0SD,MPT,cMCA,mean intensity,F2/i/and CETI scores in the 4 groups were significantly increased after treatment(P＜0.05),while CQP,NNE,CQP,GRBAS scores and VHI scores were significantly decreased(P＜0.05).After treatment,the speech rate of contin-uous speech ability in high frequency group and low frequency group was significantly increased(P＜0.05).Com-pared with those before treatment,amplitude standard deviation,mean intensity,F2/i/and CETI scores in the 4 groups were significantly increased during follow-up(P＜0.05),while NNE,GRBAS and VHI scores were signifi-cantly decreased during follow-up(P＜0.05).CQP in high frequency group was significantly decreased during fol-low-up(P＜0.05).The frenchay scores,F0SD,the speech rate of continuous speech ability,MPT and cMCA in high frequency group and low frequency group were significantly increased during follow-up(P＜0.05).The fren-chay scores,amplitude standard deviation,F0SD,the speech rate of continuous speech ability,MPT,cMCA,mean intensity,F2/i/and CETI scores in high frequency group were significantly higher than those in other groups after treatment and at follow-up(P＜0.05).CQP,NNE,GRBAS and VHI scores were significantly lower than those of other groups after treatment and at follow-up(P＜0.05).Conclusion:High frequency rTMS combined conventional articulation training can improve the articulation movement,respiratory support ability,the coordination ability of breathing and vocalization,the regularity of glottis closure,volume,oral resonance and language communication a-bility in PD patients,reduce breathing sound,hoarseness and self-subjective feelings of voice disorder,and improve monotonous intonation,mono-loudness,pronunciation delay and pause.Its efficacy is superior to conventional artic-ulation training and low frequency rTMS,and has a certain long-term effect,which is worthy of clinical promotion.
Parkinson's diseasedysarthriahigh frequencylow frequencyrepetitive transcranial magnetic stimulationarticulation trainingvoice training
万方数据
维普
