以低頻反覆性經顱磁刺激術治療中風後視覺空間忽略症：個案報告

Low Frequency Repetitive Transcranial Magnetic Stimulation in the Treatment of Visuospatial Neglect after Stroke: A Case Report

視覺空間忽略症嚴重影響病患生活品質，而有效的治療方式仍然有限。傳統的治療多重於視覺搜尋訓練，此研究探討以此磁刺激術調節頂葉區神經網絡對視覺空間忽略症的療效。一位72歲男性在右大腦梗塞後出現空間忽略及定向感失能的症狀。在左側後頂葉實施共26次的低頻反覆性經顱磁刺激術，並於治療後三個月追蹤成果。研究結果發現，在治療期間內，空間定向感與各方面的空間測試皆有顯著進步。本案例報告顯示，中風後視覺空間忽略症候群有機會藉由低頻反覆性經顱磁刺激術獲得快速且顯著的功能改善。

Visuospatial neglect (VSN) is a highly disabled syndrome and affected patient’s quality of life. Non-invasive brain stimulation has a potential role for recovery of post-stroke visuospatial neglect syndrome. Repetitive transcranial magnetic stimulation (rTMS) has been reported as a treatment for VSN. However, the stimulation site and frequency still remains controversial. This case report describes the use of low-frequency rTMS over the left parietal lobe, which facilitated the recovery of post-stroke neglect. A 72-year-old man suffered a new infarct in the right hemisphere, resulting in left hemineglect syndrome. Despite undergoing physical therapy, his recovery remained limited during the first two weeks. The patient received 26 sessions of 1Hz rTMS at left posterior parietal cortex and had significant improvement in spatial disorientation and graph drawing in the following months. Low frequency rTMS over left posterior parietal cortex might have sustained functional recovery for post-stroke patient with VSN.