Efficacy of repetitive transcranial magnetic stimulation combined with levodopa and benserazide hydrochloride tablets in the treatment of Parkinson’s disease

doi:10.3969/j.issn.1004-583X.2026.07.008

Abstract

Abstract:

Objective To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with levodopa and benserazide hydrochloride tablets in the treatment of Parkinson’s disease (PD), and to evaluate its effects on serum epidermal growth factor (EGF) and neuron-specific enolase (NSE) levels, as well as gait-related indicators. Methods A total of 246 patients with PD treated at Nanyang Central Hospital from January 2022 to January 2025 were enrolled and randomly assigned using a random number table. The control group (n=123) received levodopa and benserazide hydrochloride tablets, while the experimental group (n=123) received rTMS in combination with levodopa and benserazide hydrochloride tablets. The two groups were compared in terms of the Unified Parkinson’s Disease Rating Scale (UPDRS), serum indicators before and after treatment (EGF and NSE), gait-related indicators (Simple Test for Evaluating Hand Function [STEF], Modified Barthel Index [MBI], and Modified Ashworth Scale [MAS]), quality of life (Generic Quality of Life Inventory-74 [GQOLI-74]), and adverse reactions. Results After treatment, the UPDRS score in the experimental group was significantly lower than that in the control group (P<0.05). The experimental group had higher STEF and MBI scores and higher EGF levels, but lower NSE levels and MAS scores than the control group (P<0.05). The GQOLI-74 score in the experimental group was higher than that in the control group (P<0.05). A total of 16 patients (13.01%) in the experimental group and 14 patients (11.38%) in the control group experienced adverse reactions, with no statistically significant difference between the two groups (P>0.05). Conclusion The combination of rTMS and levodopa and benserazide hydrochloride tablets is effective in improving motor dysfunction and activities of daily living in patients with PD. Its mechanism may be related to upregulation of serum EGF and downregulation of NSE, thereby promoting neural repair. This regimen significantly improves quality of life without increasing the incidence of adverse reactions.

Key words: Parkinson's disease, repetitive transcranial magnetic stimulation, levodopa and benserazide hydrochloride tablets, epidermal growth factor, neuron-specific enolase

CLC Number:

R742.5

Xu Chongli, Zhang Xiaoying, Wang Yingya, Zhao Jing. Efficacy of repetitive transcranial magnetic stimulation combined with levodopa and benserazide hydrochloride tablets in the treatment of Parkinson’s disease[J]. Clinical Focus, 2026, 41(7): 626-631.

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References 23

[1]	孛学平, 吴鸣, 秦汉, 等. 帕金森病认知障碍康复的研究进展[J]. 中华物理医学与康复杂志, 2024, 46(3):269-272.doi:10.3760/cma.j.issn.0254-1424.2024.03.017.
[2]	陈先文, 王刚, 陈生弟. 帕金森病药物治疗研究进展[J]. 重庆医科大学学报, 2024, 49(5):542-547.doi:10.13406/j.cnki.cyxb.003498.
[3]	郑秀琴, 于苏文, 何益民, 等. 高频重复经颅磁刺激对帕金森病患者临床症状及其细胞衰老相关因子的影响[J]. 中华物理医学与康复杂志, 2022, 44(5):427-432.doi:10.3760/cma.j.issn.0254-1424.2022.05.010.
[4]	Shi X, Zheng J, Ma J, et al. Correlation between serum IGF-1 and EGF levels and neuropsychiatric and cognitive in Parkinson's disease patients[J]. Neurol Sci, 2023, 44(3):881-887.doi:10.1007/s10072-022-06490-1.
[5]	Al-Hakeim HK, Khudhair HN, Ranaei-Siadat SO, et al. Affective and chronic fatigue symptoms are associated with serum neuronal damage markers in Parkinson's disease[J]. Sci Rep, 2025, 15(1):20647.doi:10.1038/s41598-025-07735-7.
[6]	陈海波, 武冬冬. 帕金森病基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2020, (1):5-6.doi:10.3760/cma.j.issn.1671-7368.2020.01.003.
[7]	Lefaucheur JP, Aleman A, Baeken C, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018)[J]. Clin Neurophysiol, 2020, 131(2):474-528.doi:10.1016/j.clinph.2019.11.002.
[8]	Khalil H, Aldaajani ZF, Aldughmi M, et al. Validation of the arabic version of the movement disorder society-unified Parkinson's disease rating scale[J]. Mov Disord, 2022, 37(4):826-841.doi:10.1002/mds.28905.
[9]	张晓雪, 王睿月, 樊虹玉, 等. 上肢功能测试量表的汉化及其在脑卒中患者中的信效度研究[J]. 中国全科医学, 2023, 26(8):1022-1027.doi:10.12114/j.issn.1007-9572.2022.0391.
[10]	闵瑜, 吴媛媛, 燕铁斌. 改良Barthel指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究[J]. 中华物理医学与康复杂志, 2008(3):185-188.doi:10.3321/j.issn:0254-1424.2008.03.010.
[11]	Meseguer-Henarejos AB, Sánchez-Meca J, López-Pina JA, et al. Inter-and intra-rater reliability of the modified ashworth scale: A systematic review and meta-analysis[J]. Eur J Phys Rehabil Med, 2018, 54(4):576-590.doi:10.23736/S1973-9087.17.04796-7.
[12]	Xie YE, Huang WC, Li YP, et al. Dynamic interaction nursing intervention on functional rehabilitation and self-care ability of patients after aneurysm surgery[J]. World J Clin Cases, 2022, 10(15):4827-4835.doi:10.12998/wjcc.v10.i15.4827.
[13]	陈秋霞, 李蒙燕, 王婷. 帕金森病治疗现状及新进展[J]. 中华行为医学与脑科学杂志, 2024, 33(9):807-812.doi:10.3760/cma.j.cn371468-20240512-00220.
[14]	Yang T, Liu W, He J, et al. The cognitive effect of non-invasive brain stimulation combined with cognitive training in Alzheimer's disease and mild cognitive impairment:A systematic review and meta-analysis[J]. Alzheimers Res Ther, 2024, 16(1):140.doi:10.1186/s13195-024-01505-9.
[15]	Li G, Huang P, Cui SS, et al. Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson's disease patients[J]. Transl Neurodegener, 2022, 11(1):6.doi:10.1186/s40035-022-00280-7. pmid: 35125106
[16]	时洁, 耿晓康, 李潇, 等. rTMS联合普拉克索治疗老年帕金森病患者疗效及对步态指标和血清S100βNSEBDNF水平的影响[J]. 河北医学, 2024, 30(8):1362-1367.doi:10.3969/j.issn.1006-6233.2024.08.025.
[17]	Ryan D, Fullen B, Rio E, et al. Effect of action observation therapy in the rehabilitation of neurologic and musculoskeletal conditions: A systematic review[J]. Arch Rehabil Res Clin Transl, 2021, 3(1):100106.doi:10.1016/j.arrct.2021.100106.
[18]	den Heijer JM, Kruithof AC, Moerland M, et al. A Phase 1B Trial in GBA1-associated Parkinson's disease of BIA-28-6156, a glucocerebrosidase activator[J]. Mov Disord, 2023, 38(7):1197-1208.doi:10.1002/mds.29346.
[19]	葛静雅, 刘慧群, 刘畅, 等. 疏风平颤汤加减联合STN-DBS手术对帕金森病病人EGF, 抗氧化功能的影响[J]. 中西医结合心脑血管病杂志, 2022, 20(11):2069-2073.doi:10.12102/j.issn.1672-1349.2022.11.033.
[20]	赵轶, 左博, 贾佳, 等. 血清S100β, NSE, BDNF水平与帕金森病合并认知功能障碍的相关性>BDNF水平与帕金森病合并认知功能障碍的相关性[J]. 中国临床医学, 2023, 30(4):652-657.doi:10.12025/j.issn.1008-6358.2023.20230782.
[21]	Cao H, Zuo C, Gu Z, et al. High frequency repetitive transcranial magnetic stimulation alleviates cognitive deficits in 3xTg-AD mice by modulating the PI3K/Akt/GLT-1 axis[J]. Redox Biol, 2022, 54:102354.doi:10.1016/j.redox.2022.102354.
[22]	李晓莉, 李冬春, 王昌图, 等. 重复经颅磁刺激治疗帕金森的临床疗效[J]. 川北医学院学报, 2024, 39(10):1317-1320.doi:10.3969/j.issn.1005-3697.2024.10.005.
[23]	康乐乐, 苗婵婵, 高海茸. 多巴丝肼联合重复经颅直流电刺激治疗对帕金森疾病患者运动和非运动功能的影响[J]. 川北医学院学报, 2024, 39(8):1059-1063.doi:10.3969/j.issn.1005-3697.2024.08.013.

指标	例数	性别 (男/女)		年龄 (岁)		病程 (年)		Hoehn-Yahr分期[例(%)]
指标	例数	性别 (男/女)		年龄 (岁)		病程 (年)		Ⅰ期		Ⅱ期		Ⅲ期		Ⅳ期
试验组	123	61/62		70.47±4.34		2.78±0.34		28(22.76)		45(36.59)		32(26.02)		18(14.63)
对照组	123	60/63		71.12±4.28		2.71±0.36		30(24.39)		43(34.96)		31(25.20)		19(15.45)
t/χ²值		0.033		1.073		1.562		0.268
P值		0.856		0.284		0.120		0.966
指标	UPDRS- 精神行为(分)		UPDRS- 运动功能(分)		UPDRS-日常生活能力(分)		MMSE (分)		HAMD (分)		HAMA (分)		LED (mg/d)
试验组	12.36±1.12		46.87±3.91		57.56±5.12		26.34±2.21		18.23±3.45		17.89±3.21		412.35±45.67
对照组	12.21±1.04		46.50±3.46		58.05±4.34		26.51±2.08		18.09±3.52		18.02±3.34		408.92±46.23
t/χ²值	1.073		0.796		0.810		0.620		0.319		0.316		0.589
P值	0.284		0.427		0.419		0.536		0.750		0.752		0.556

指标	例数	性别 (男/女)		年龄 (岁)		病程 (年)		Hoehn-Yahr分期[例(%)]
指标	例数	性别 (男/女)		年龄 (岁)		病程 (年)		Ⅰ期		Ⅱ期		Ⅲ期		Ⅳ期
试验组	123	61/62		70.47±4.34		2.78±0.34		28(22.76)		45(36.59)		32(26.02)		18(14.63)
对照组	123	60/63		71.12±4.28		2.71±0.36		30(24.39)		43(34.96)		31(25.20)		19(15.45)
t/χ²值		0.033		1.073		1.562		0.268
P值		0.856		0.284		0.120		0.966
指标	UPDRS- 精神行为(分)		UPDRS- 运动功能(分)		UPDRS-日常生活能力(分)		MMSE (分)		HAMD (分)		HAMA (分)		LED (mg/d)
试验组	12.36±1.12		46.87±3.91		57.56±5.12		26.34±2.21		18.23±3.45		17.89±3.21		412.35±45.67
对照组	12.21±1.04		46.50±3.46		58.05±4.34		26.51±2.08		18.09±3.52		18.02±3.34		408.92±46.23
t/χ²值	1.073		0.796		0.810		0.620		0.319		0.316		0.589
P值	0.284		0.427		0.419		0.536		0.750		0.752		0.556

组别	例数	精神行为		运动功能		日常生活能力
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
试验组	123	12.36±1.12	5.34±1.06^*	46.87±3.91	30.01±4.06^*	57.56±5.12	37.57±5.17^*
对照组	123	12.21±1.04	7.51±1.48^*	46.50±3.46	34.98±5.64^*	58.05±4.34	42.54±6.74^*
t值		1.073	13.328	0.796	7.764	0.810	6.618
P值		0.284	<0.01	0.427	<0.01	0.419	<0.01

组别	例数	精神行为		运动功能		日常生活能力
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
试验组	123	12.36±1.12	5.34±1.06^*	46.87±3.91	30.01±4.06^*	57.56±5.12	37.57±5.17^*
对照组	123	12.21±1.04	7.51±1.48^*	46.50±3.46	34.98±5.64^*	58.05±4.34	42.54±6.74^*
t值		1.073	13.328	0.796	7.764	0.810	6.618
P值		0.284	<0.01	0.427	<0.01	0.419	<0.01

组别	例数	EGF(ng/L)		NSE(μg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后
试验组	123	4.34±0.55	7.03±0.77^*	18.42±2.31	7.76±1.39^*
对照组	123	4.37±0.52	6.24±0.71^*	18.24±4.34	9.05±1.34^*
t值		0.521	9.428	0.472	8.937
P值		0.603	<0.01	0.637	<0.01