| Objective:In this study,we used high-frequency(HF)repetitive transcranial magnetic stimulation(rTMS)to treat Parkinson’s disease(PD)with the freezing of gait.We compared the changes of each index pretherapy and post-treatment,analyzed the efficacy,and found the best treatment parameters,so as to provide certain therapeutic value for clinical workers.Method:(1)According to the inclusion criteria and exclusion criteria,fifty-two clinically confirmed patients with primary PD and FOG in the Department of Neurology,Affiliated Hospital of Hebei University from February 2019 to December 2020 were selected.(2)fifty-two patients with PD and FOG were randomly divided into A,B,C three groups,17 patients in group A,1 lost to follow-up;17 patients in group B,1 lost to follow-up;There were18 patients in group C,2 lost to follow-up,and 48 patients were eventually enrolled.patients in the three groups were treated with HF-rTMS at 5 Hz,10 Hz and 25 Hz respectively by rTMS.(3)One day before treatment(T0),10 th day of treatment(T1),and one month after treatment(T2),all patients stopped using anti-PD drugs for 12 hours.Then they were assessed with Movement disorder society-unified Parkinson disease rating scale(MDS-UPDRS Ⅲ),HoehnYahr staging(H-Y),The new freezing of gait questionnaire(NFOGQ),The timed up and go test(TUGT),Montreal cognitive assessment(Mo CA),Mini-mental state exam(MMSE),Hamilton anxiety scale(HAMA),Hamilton’s depression scale(HAMD)and Life event scale(LES),and scores of each scale were recorded.By comparing the changes of scores of each scale within and between groups pretherapy and post-treatment,to evaluate the therapeutic effect of HF-rTMS on PD patients with FOG and find out the best treatment parameters.Results:1.There was no statistical difference in MDS-UPDRS Ⅲ scores of the three groups at T0(P>0.05).After treatment,MDS-UPDRS Ⅲ scores of the three groups were decreased at T1 and T2,and the difference was statistically significant compared with that at T0(P<0.05).Multiple comparisons were made between the three groups,and there was statistical significance between group A and group B(P=0.049<0.05),group A and group C(P=0.023<0.05);There was no statistical significance between group B and group C(P=0.075>0.05).⒉There was no statistical difference in NFOGQ,TUGT scores of the three groups at T0(P>0.05).After treatment,NFOGQ,TUGT scores of the three groups were decreased at T1 and T2,and the difference was statistically significant compared with that at T0(P<0.05).Multiple comparisons were made between the three groups,and there was statistical significance between group A and group B(P<0.05);There was no statistical significance between group A and group C,group B and group C(P>0.05).⒊There was no statistical difference in MMSE scores of the three groups at T0(P>0.05).After treatment,MMSE scores of the three groups were significantly increased at T1 and T2,and the difference was statistically significant compared with that at T0(P<0.05).Multiple comparisons were made between the three groups,and there was statistical significance between group A and group B(P=0.048<0.05),group A and group C(P=0.006<0.05);There was no statistical significance between group B and group C(P=0.387>0.05).⒋There was no statistical difference in Mo CA,HAMA,HAMD scores of the three groups at T0(P>0.05).After treatment,Mo CA,HAMA,HAMD scores of the three groups were improved at T1 and T2,and the difference was statistically significant compared with that at T0(P<0.05).There was no statistical difference between A,B and C(P>0.05).Conclusion:1.HF-rTMS can improve motor symptoms and cognitive,anxiety,depression symptoms of non-motor symptoms in PD with FOG patients.2.25 Hz HF-rTMS significantly improved the Freezing of gait and cognitive function of PD with FOG patients compared with 10 Hz and 5 Hz. |
