经颅磁刺激治疗改善帕金森病：机制、 临床实践及未来展望

Transcranial Magnetic Stimulation for Improving Parkinson’s Disease: Mechanisms, Clinical Practice, and Future Perspectives

摘要: 经颅磁刺激(Transcranial Magnetic Stimulation, TMS)是近年来新欣的非侵入性的神经调控技术，已广泛运用于各种中枢神经系统退行性疾病。因其具有无创、可调控等特点，在帕金森病(Parkinson’s Disease, PD)的治疗中展现出较为可观的发展前景。TMS通过调节大脑皮层的神经活动，改善运动症状(如运动迟缓、僵硬、震颤)以及非运动症状(如抑郁、认知功能、执行功能)。在初级运动皮层(Primary Motor Cortex, M1)和背外侧前额叶皮层(Dorsolateral Prefrontal Cortex, DLPFC)给予高频TMS刺激后，PD患者的运动症状和情绪可有明显改善，提示TMS在PD患者的运动症状和非运动症状治疗方面有一定的应用潜力。然而，TMS的疗效在不同研究中存在异质性，且治疗方案(如频率、靶区、治疗次数)缺乏统一标准，导致疗效不一致。尽管如此，TMS仍被认为是一种安全的治疗方法，副作用通常较轻。未来的研究将着重于个性化治疗方案的优化、TMS与其他治疗方式的联合应用，以及长期疗效和机制的深入探索，进一步提高其在PD治疗中的临床价值。

Abstract: Transcranial magnetic stimulation (TMS) is a recently emerging, noninvasive neuromodulation technique that has been widely applied to a range of neurodegenerative diseases of the central nervous system. Owing to its noninvasive and adjustable nature, TMS has shown considerable potential for development in the treatment of Parkinson’s disease (PD). By modulating neuronal activity in the cerebral cortex, TMS can improve both motor symptoms (e.g., bradykinesia, rigidity, and tremor) and non-motor symptoms (e.g., depression, cognitive function, and executive function). After high-frequency TMS stimulation is applied to the primary motor cortex (M1) and the dorsolateral prefrontal cortex (DLPFC), patients with Parkinson’s disease (PD) may experience marked improvements in motor symptoms and mood, suggesting that TMS has potential clinical value for treating both motor and non-motor symptoms in PD. However, treatment outcomes vary across studies, and there is no unified standard for stimulation protocols (e.g., frequency, target site, and number of sessions), resulting in inconsistent efficacy. Nevertheless, TMS is generally considered safe, with adverse effects typically mild. Future research will focus on optimizing personalized treatment protocols, combining TMS with other therapeutic approaches, and further elucidating its long-term efficacy and underlying mechanisms to enhance its clinical value in PD management.