房海静,刘 梅

脑卒中是全球首要致残性疾病，我国年发病率达246.8/10万，约60%-80%幸存者遗留运动、语言、认知或吞咽功能障碍，其中卒中后抑郁发生率高达33%，严重影响患者生活质量和社会参与。传统康复及药物治疗存在疗效瓶颈和副作用风险。重复经颅磁刺激（rTMS）作为一种非侵入性神经调控技术，通过调节皮质兴奋性和神经可塑性，在改善多种卒中后功能障碍中展现出显著潜力[1-3]。目的：本综述旨在系统总结rTMS在改善脑卒中患者运动、语言、吞咽、认知及情绪功能障碍中的应用证据、疗效机制、现存挑战及未来方向，为临床转化提供循证依据。结论：rTMS作为一种非侵入性神经调控技术，在促进脑卒中后神经可塑性、改善多种功能障碍方面展现出潜力，但其最佳参数、长期疗效及个体化方案仍需更多高质量研究探索。

重复经颅磁刺激；脑卒中；运动功能；失语症；吞咽困难；认知功能障碍；卒中后抑郁

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