Abstract: Objective To preliminarily evaluate the efficacy of accelerated high-dose repetitive transcranial magnetic stimulation (rTMS) on freezing of gait (FOG) in patients with Parkinson's disease (PD). Methods Twenty-eight PD patients with FOG were recruited from the Parkinson's Disease Clinic of the First Affiliated Hospital of Anhui Medical University between 2020-2023.Participants received five consecutive days of accelerated high-dose rTMS treatment.Assessments using the Timed Up-and-Go (TUG) test and Standing-Start 180°Turn Test (SS-180) were conducted at baseline,1 day post-treatment,and 5 days post-treatment.The TUG score difference (ΔTUG) between baseline and 1-day post-treatment was analyzed for correlation with baseline measures including TUG,SS-180,Unified Parkinson's Disease Rating Scale Part III (UPDRS-III),Freezing of Gait Questionnaire (FOGQ),disease duration,Mini-Mental State Examination (MMSE),Montreal Cognitive Assessment (MoCA),and Digital Span Test (DST). Results 1.Therapeutic outcomes,The TUG and SS-180 scores showed significant improvement from baseline at both 1 day and 5 days post-treatment (all P＜0.001).A statistically significant difference was observed in TUG scores between 1 day and 5 days post-treatment (P＜0.05).However,the difference in SS-180 scores between 1 day and 5 days post-treatment was not statistically significant (P＞0.05).2.Correlation analysis,ΔTUG showed positive correlations with baseline TUG,SS-180,FOGQ,and UPDRS-III scores.ΔTUG demonstrated negative correlations with MMSE,MoCA,and DST scores. Conclusion Accelerated high-dose rTMS provides rapid improvement in freezing of gait in PD,particularly in patients with more severe baseline FOG and greater cognitive dysfunction.

Key words: Freezing of Gait, Repetitive transcranial magnetic stimulation, Accelerated High-Dose, Cognition

摘要： 目的 初步探讨超大剂量重复经颅磁刺激对帕金森病冻结步态的疗效。方法 纳入2020-2023年安徽医科大学第一附属医院帕金森病门诊的28例PD-FOG患者,接受连续5天的超大剂量rTMS治疗。分别于治疗前、治疗1天后及治疗5天后采用5米起立行走测试和180°直立旋转测试评估疗效,并分析治疗前与治疗1天后的TUG差值(ΔTUG)与基线指标,包括治疗前TUG、治疗前SS-180、统一帕金森病评定量表第三部分(UPDRS-III)、冻结步态问卷(FOGQ)、病程、简易精神状态量表(MMSE)、蒙特利尔认知评估(MoCA)及数字广度测验(DST)等的相关性。结果 ①疗效分析,治疗1天后及治疗5天后的TUG、SS-180值较基线显著改善(均P＜0.001);治疗1天后与治疗5天后的TUG值进行比较,两者之间差异亦有统计学意义(P＜0.05),但治疗1天后与治疗5天后的SS-180值进行比较,差异无统计学意义(P＞0.05);②相关性分析,△TUG与治疗前TUG、治疗前SS-180、FOGQ及UPDRS-III呈正相关;△TUG与MMSE、MoCA及DST呈负相关。结论 超大剂量rTMS治疗可快速改善PD患者的冻结步态,并且基线冻结步态症状越严重、认知功能受损越明显的患者疗效更佳。

关键词: 冻结步态, 重复经颅磁刺激, 超大剂量, 认知功能