| Objective: The purpose of this study is to evaluate the clinical efficacy of spinocerebellar ataxia type 3(SCA3)under the intervention of high frequency repetitive transcranial magnetic stimulation(rTMS);and rTMS Before and after the intervention,changes in Proton magnetic resonance spectroscopy(1H-MRS)and their possible mechanisms were explored.Methods: This study is a single-center,double-blind,randomized,controlled experiment.A total of 27 patients with total spinocerebellar disorder type 3 diagnosed by genetic testing were enrolled and randomly divided into experimental group and control group.The Scale for Assessment and Rating of Ataxia(SARA),the International Cooperative Ataxia Rating Scale(ICARS)and magnetic resonance imaging scans were performed before and after rTMS stimulation.Then,high-frequency repetitive transcranial magnetic stimulation(10Hz)was performed for1 hour every day,and the stimulation sites were divided into left cerebellar hemisphere,cerebellar vermis,and right cerebellar hemisphere.A total of 2400 pulses,20 minutes per site,a total of 10 sessions,5 consecutive days,with a 2-day rest in between.Finally,data processing was carried out,and SPSS 26 was used for statistical analysis.Results: 1.In the experimental group,the SARA total score and ICARS total score of the patients after rTMS treatment were significantly decreased,and the scores of finger tracking,finger-nose test,posture and gait,and dynamic function in the sub-items were all decreased,with statistical significance,(p < 0.05);in the control group,there was no significant change in each scale after rTMS stimulation,and the results were not statistically different(p > 0.05).2.The ratios of NAA/Cr,Cho/Cr and NAA/Cho in the cerebellar vermis of the experimental group changed significantly after rTMS treatment,and the results were statistically different(p<0.05).The NAA/Cr in the left dentate nucleus There was a strong negative correlation between concentration and dynamic function(r=-0.557,p<0.05).The SARA total score(r=-0.505,p<0.05)and the ICARS total score(r=-0.557,p<0.05)were moderately negatively correlated with the NAA/Cr concentration in the dentate nucleus.Conclusion: This study found that high-frequency repetitive transcranial magnetic stimulation can improve the ataxia symptoms of spinocerebellar ataxia type3;the improvement of ataxia symptoms after rTMS treatment is related to the changes of cerebellar metabolites.After rTMS treatment,the ICARS and SARA scores of SCA3 patients were reduced,and the treatment had a certain effect. |
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