时序cTBS-iTBS双靶点协同增强腹背侧语言环路对脑卒中后失语症的临床疗效观察

注册号:

Registration number:

ChiCTR2600130825 

最近更新日期:

Date of Last Refreshed on:

2026-08-25 16:01:06 

注册时间:

Date of Registration:

2026-08-25 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

时序cTBS-iTBS双靶点协同增强腹背侧语言环路对脑卒中后失语症的临床疗效观察

Public title:

An Observation of the Clinical Efficacy of Temporal cTBS-iTBS Dual-Target Synergistic Enhancement of the Ventrolateral and Dorsolateral Language Circuits in Post-Stroke Aphasia

注册题目简写:

English Acronym:

研究课题的正式科学名称:

时序cTBS-iTBS双靶点协同增强腹背侧语言环路对脑卒中后失语症的临床疗效观察

Scientific title:

An Observation of the Clinical Efficacy of Temporal cTBS-iTBS Dual-Target Synergistic Enhancement of the Ventrolateral and Dorsolateral Language Circuits in Post-Stroke Aphasia

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

夏家怡 

研究负责人:

夏家怡 

Applicant:

Jiayi Xia 

Study leader:

Jiayi Xia 

申请注册联系人电话:

Applicant telephone:

+86 21 6618 1108

研究负责人电话:

Study leader's
telephone:

+86 21 6618 1108

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

532821681@qq.com

研究负责人电子邮件:

Study leader's E-mail:

532821681@qq.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

上海市宝山区长江路860弄25号

研究负责人通讯地址:

上海市宝山区 长江路860弄25号

Applicant address:

25 Lane, 860 Changjiang Road, Baoshan District, Shanghai

Study leader's address:

No.25, Lane 860, Changjiang Road Baoshan District, Shanghai

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

上海市第二康复医院

Applicant's institution:

The second Rehabilitation Hospital of Shanghai

研究负责人所在单位:

上海市第二康复医院

Affiliation of the Leader:

Shanghai Second Rehabilitation Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025-26-01

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

上海市第二康复医院伦理委员会

Name of the ethic committee:

Ethics Committee of Shanghai Second Rehabilitation Hospital Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2025-11-20 00:00:00

伦理委员会联系人:

陈叶萍

Contact Name of the ethic committee:

Yeping Chen

伦理委员会联系地址:

上海市宝山区 长江路860弄25号

Contact Address of the ethic committee:

No.25, Lane 860, Changjiang Road Baoshan District, Shanghai

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 21 66181108

伦理委员会联系人邮箱:

Contact email of the ethic committee:

2211497824@qq.com

研究实施负责(组长)单位:

上海市第二康复医院

Primary sponsor:

Shanghai Second Rehabilitation Hospital

研究实施负责(组长)单位地址:

上海市宝山区 长江路860弄25号

Primary sponsor's address:

No.25, Lane 860, Changjiang Road Baoshan District, Shanghai

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海市

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市第二康复医院

具体地址:

上海市宝山区长江路860弄25号

Institution
hospital:

Shanghai Second Rehabilitation Hospital

Address:

Baoshan District, ShanghaiNo.25, Lane 860, Changjiang Road

经费或物资来源:

上海市卫生健康委员科研项目

Source(s) of funding:

Research Projects of the Shanghai Municipal Health Commission

研究疾病:

脑卒中  

Target disease:

stroke

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

探索性研究/预试验 

Study phase:

0

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

1、通过病例对照研究,探讨PSA在真实语言交流情境下的脑活动特征,由此开展试验干预。 2、通过干预性研究,探讨时序cTBS-iTBS双靶点协同增强腹背侧语言环路对脑卒中后失语症语言功能恢复的临床疗效,为PSA早期精准磁刺激治疗提供科学依据,推广一套操作简便、成本可控的康复方案。  

Objectives of Study:

1. To investigate the characteristics of brain activity associated with PSA in real-life language communication contexts through a case-control study, and to use this as a basis for developing an intervention trial. 2. Through an interventional study, to investigate the clinical efficacy of sequential cTBS-iTBS dual-target synergistic enhancement of the ventrolateral-dorsolateral language circuit in the recovery of language function following aphasia caused by stroke; to provide a scientific basis for early, precision magnetic stimulation treatment of PSA; and to promote a rehabilitation programme that is simple to administer and cost-effective.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.并发其他神经退行性疾病,如帕金森病等;
2.应用改变大脑皮质兴奋性的药物(抗癫痫药物)、安眠药、苯二氮草类药物等;
3.有精神异常史;
4.癫痫;
5.严重心、肝、肾功能障碍或其他严重身体疾病;
6.昏迷,不能配合检查和治疗;
7.听觉或视觉缺陷可能影响评估和治疗;
8.根据安全指南,体内有金属异物或体内植入其他电子设备不宜行rTMS治疗者;

Exclusion criteria:

1. Concurrent with other neurodegenerative diseases, such as Parkinson’s disease, etc. 2. Medicines that alter cortical excitability (anti-epileptic drugs), sleeping pills, benzodiazepines, etc. 3. A history of mental health problems; 4. Epilepsy; 5. Severe heart, liver or kidney dysfunction, or other serious medical conditions; 6. Unconscious; unable to cooperate with examinations and treatment; 7. Hearing or visual impairments may affect assessment and treatment; 8. According to the safety guidelines, individuals with metallic foreign bodies or other implanted electronic devices should not undergo rTMS treatment;

研究实施时间:

Study execute time:

From 2025-09-01 00:00:00 To 2028-08-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-09-01 00:00:00 To 2028-08-31 00:00:00

干预措施:

Interventions:

组别:

第二组

样本量:

23

Group:

Group 2

Sample size:

干预措施:

非时序cTBS-iTBS双靶点调控

干预措施代码:

Intervention:

Non-temporal cTBS-iTBS dual-target regulation

Intervention code:

组别:

第一组

样本量:

23

Group:

Group 1

Sample size:

干预措施:

时序cTBS-iTBS双靶点调控

干预措施代码:

Intervention:

Time-Series cTBS-iTBS Dual-Target Regulation

Intervention code:

组别:

第三组

样本量:

23

Group:

Group 3

Sample size:

干预措施:

假cTBS+假iTBS

干预措施代码:

Intervention:

Sham cTBS + Sham iTBS

Intervention code:

组别:

健康对照组

样本量:

23

Group:

Health control group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

PSA患者组

样本量:

23

Group:

PSA patient group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海市 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市第二康复医院 

单位级别:

二级乙等 

Institution
hospital:

Shanghai Second Rehabilitation Hospital

Level of the institution:

Secondary B

测量指标:

Outcomes:

指标中文名:

实用语言交流能力检查表

指标类型:

次要指标

Outcome:

Communicative Abilities in Daily Living

Type:

Secondary indicator

测量时间点:

0、2、4、8周

测量方法:

该量表的交流能力分为5个等级0~33分为1级,表示交流能力水平为全部帮助:34~67分为2级,交流能力水平为大部分帮助;68~92分为3级,交流能力水平为部分帮助;93-115分为4级,交流能力水平为有一定实用性;116~136分为5级,交流能力水平为基本自理。采用CADL对失语症程度进行分级,并对疗效进行评价。显效:治疗后,CADL分级提高>2级;有效:治疗后,CADL分级至少提高1级;无效:治

Measure time point of outcome:

0, 2, 4, 8 weeks

Measure method:

The scale classifies communication ability into five levels: 0–33 points is Level 1, indicating a level of communication ability requiring full assistance; 34–67 points is Level 2, indicating a level of communication ability requiring mostly assistance; 68–92 points is Level 3, indicating a level of communication ability requiring some assistance; 93–115 points is Level 4, indicating a level of communication ability with some practical utility; and 116–136 points is Level 5, indicating a level o

指标中文名:

西方失语症成套测验

指标类型:

主要指标

Outcome:

Westemm Aphasia Battery

Type:

Primary indicator

测量时间点:

0、2、4、8周

测量方法:

选取该测验中自发言语、听理解、复述、命名四个版块进行评估,其总分依次为20、10、10、10分;并计算失语指数,失语指数AQ=各项得分之和*2。失语指数<93.8分判定为失语,各项得分越高提示患者语言功能恢复越好。

Measure time point of outcome:

0, 2, 4, 8 weeks

Measure method:

The assessment focuses on four sections of this test: spontaneous speech, listening comprehension, retelling and naming, with total scores of 20, 10, 10 and 10 points respectively; the aphasia index (AQ) is calculated as the sum of the individual scores multiplied by 2. An aphasia index of <93.8 points indicates aphasia, whilst higher scores in each section suggest better recovery of the patient’s language function.

指标中文名:

波士顿诊断性失语症检查

指标类型:

次要指标

Outcome:

Boston Diagnostic Aphasia Examination

Type:

Secondary indicator

测量时间点:

0、2、4、8周

测量方法:

有0-5级,共6个等级评价失语症严重程度,分级标准:0级:无有意义的语言表达:1级:有断断续续的语言表达,需要听者询问活推测,交流很困难:2级:可以交谈患者熟悉的话题,但对陌生话题无法表达自己的思想,交流有一点困难;3级:在无帮助或仅需少量帮助下,患者可以进行日常问题的讨论,但由于表达或理解力受限,仍有部分谈话感到困难;4级:语言流利,可察觉到一定的理解障碍,但思想、语言表达无障碍:5级:基本察觉

Measure time point of outcome:

0, 2, 4, 8 weeks

Measure method:

There are six levels, ranging from 0 to 5, for assessing the severity of aphasia. The grading criteria are as follows: Level 0: No meaningful verbal expression; Level 1: Intermittent verbal expression; the listener must ask questions or make inferences, and communication is very difficult; Level 2: The patient can converse on familiar topics but is unable to express their thoughts on unfamiliar topics; communication is somewhat difficult; Level 3: The patient can discuss everyday matters with li

指标中文名:

脑电图评估

指标类型:

次要指标

Outcome:

electroencephalography,EEG

Type:

Secondary indicator

测量时间点:

0、2、4、8周

测量方法:

采用多通道脑电设备采集患者静息态/任务态脑电信号,主要分析δ、θ、α、β等频段的脑电功率及语言相关脑区间的功能连接变化,比较干预前后脑电活动及网络同步性的改变。

Measure time point of outcome:

0, 2, 4, 8 weeks

Measure method:

Multi-channel EEG equipment was used to record patients’ resting-state and task-related EEG signals. The study primarily analysed EEG power in the δ, θ, α and β frequency bands, as well as changes in functional connectivity within language-related brain regions, and compared changes in EEG activity and network synchrony before and after the intervention.

指标中文名:

患者满意度

指标类型:

次要指标

Outcome:

Patient satisfaction

Type:

Secondary indicator

测量时间点:

0、2、4、8周

测量方法:

受试者或家属或陪护人员自我满意度评价:在4周治疗结束后,采用问卷法评估治疗效果,让受试者或家属或陪护人员从治愈、显效、有效、无效四项中选择一项。

Measure time point of outcome:

0, 2, 4, 8 weeks

Measure method:

Self-assessment of satisfaction by participants, family members or carers: At the end of the 4-week treatment period, the effectiveness of the treatment was assessed using a questionnaire, in which participants, family members or carers were asked to select one of the following four options: ‘cured’, ‘marked improvement’, ‘improvement’ or ‘no improvement’.

指标中文名:

功能性磁共振检查

指标类型:

次要指标

Outcome:

Functional magnetic resonance imaging

Type:

Secondary indicator

测量时间点:

0、2、4、8周

测量方法:

选取部分患者,尝试进行影像学fMRI评估。评估在3.0T西门子MAGNETOM Turbo Skyra平台上完成,首先采用横轴位自旋回波T1WI获取整体解剖参考(TR=156ms,TE=2.46ms,层厚5mm)并执行三维MPRAGE(TR=1650ms,TE=2.35ms,层厚1mm)以用于高分辨配准和病灶体积定量;随后利用单次激发EPI序列采集静息态BOLD信号,结合头动校正、时间漂移校正与T

Measure time point of outcome:

0, 2, 4, 8 weeks

Measure method:

A subgroup of patients was selected to undergo fMRI assessment. The assessment was performed on a 3.0T Siemens MAGNETOM Turbo Skyra system. First, a transverse spin-echo T1-weighted image (T1WI) was acquired to establish a general anatomical reference (TR = 156 ms, TE = 2.46 ms, slice thickness 5 mm), followed by a three-dimensional MPRAGE (TR = 1650 ms, TE = 2.35 ms, slice thickness 1 mm) was performed for high-resolution registration and lesion volume quantification; Subsequently, single-excit

指标中文名:

功能性近红外检测

指标类型:

次要指标

Outcome:

Functional near-infrared detection

Type:

Secondary indicator

测量时间点:

0、2、4、8周

测量方法:

使用近红外脑功能成像系统采集受试者数据。以连续波形式记录两种不同波长的近红外光(690nm和830nm)信号,采样频率为10Hz,可实时检测受试者大脑中脱氧血红蛋白和含氧血红蛋白(oxygenate hemoglobin,Oxy-Hb)的浓度变化。

Measure time point of outcome:

0, 2, 4, 8 weeks

Measure method:

Data from participants were acquired using a near-infrared brain functional imaging system. Signals from near-infrared light at two different wavelengths (690 nm and 830 nm) were recorded in continuous-wave mode at a sampling frequency of 10 Hz, enabling real-time detection of changes in the concentrations of deoxyhaemoglobin and oxygenated haemoglobin (Oxy-Hb) in the participants’ brains.

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NA

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 100 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

由本研究中不参与受试者招募、干预实施及结局评估的独立研究人员采用随机数表法产生随机分组序列,按照1:1:1比例将受试者随机分配至3组。

Randomization Procedure (please state who generates the random number sequence and by what method):

An independent researcher, who was not involved in participant recruitment, the delivery of the intervention or the assessment of outcomes in this study, generated a randomisation sequence using a random number table and randomly allocated participants to three groups in a 1:1:1 ratio.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

单盲,对评估者设盲

Blinding:

Single blind study with blinded-evaluators

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

研究完成并主要研究结果发表后,可根据合理申请向符合条件的研究者提供经过去标识化处理的个体受试者数据及相关研究方案,具体共享内容由研究团队审核确定。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

After completion of the study and publication of the main results, de-identified individual participant data and relevant study protocol may be made available to qualified researchers upon reasonable request, subject to review and approval by the research team.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

采用标准化病例报告表(Case Record Form,CRF)进行研究数据采集,并建立电子数据库进行统一管理。研究人员按照统一操作规范录入数据,采用双人核对和定期质量控制方式保证数据的完整性和准确性。受试者采用唯一研究编号进行去标识化管理,电子数据设置访问权限并定期备份。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Study data will be collected using standardized Case Report Forms (CRFs) and managed in an electronic database. Data will be entered according to standardized procedures and checked by two researchers with regular quality control to ensure completeness and accuracy. Each participant will be identified by a unique study code, and electronic data will be access-controlled and regularly backed up.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-08-25 16:00:47