rTMS联合普拉克索治疗老年帕金森病患者疗效及对步态指标和血清S100β NSE BDNF水平的影响

doi:10.3969/j.issn.1006-6233.2024.08.025

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Abstract Objective: To explore the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with pramipexole in the treatment of elderly patients with Parkinson' s disease (PD) and its impact on gait indicators, serum central nervous specific protein (S100β), neuron-specific enolase (NSE), and brain-derived neurotrophic factor (BDNF).Methods: A total of 102 elderly inpatients diagnosed with PD from May 2020 to May 2023 were included in this study. Patients were divided into medication group (single) and combined treatment group (double) using odd and even numbers, with 51 patients in each group. Patients in the medication group received pramipexole therapy starting at 0.125 mg three times daily, increasing weekly up to a maximum of 4.5 mg/day. Patients in the combined treatment group received rTMS in addition to pramipexole, with one session per day for 5 days followed by 2 days of rest, for a total of 8 weeks of treatment. Clinical efficacy, emotional function, gait parameters, cortical excitability indices, serum biochemical parameters, and adverse reactions were compared between the two groups.Results: The total effective rate in the combined treatment group (86.27%) was higher than that in the medication group (68.63%) (P<0.05). After treatment, both groups showed significant decreases in HAMD and FAQ scores (P<0.05). Post-treatment, STEF and BBS scores increased while MAS scores decreased in both groups, with MAS scores lower in the combined treatment group (P<0.05). MEP decreased, and RMT and CMCT increased significantly post-treatment in both groups (P<0.05). Post-treatment, S100β and NSE levels decreased while BDNF levels increased significantly in both groups (P<0.05). There was no significant difference in the incidence of adverse reactions between the combined treatment group (9.80%) and the medication group (7.84%) (P>0.05).Conclusion: rTMS combined with pramipexole effectively treats elderly patients with PD, improving emotional, motor, and neurological functions with a high safety profile. This combined approach warrants further promotion in clinical practice.

Key words： Repetitive transcranial magnetic stimulation Pramipexole Elderly parkinson's disease

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.08.025 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I8/1362

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