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蔡泊意

科別: 復健科

 

姓名: 蔡泊意
學歷 中國醫藥大學醫學系
經歷/進修 臺北榮民總醫院復健醫學部住院醫師
臺北榮民總醫院復健醫學部總醫師 
美國克里夫蘭醫學中心進修
現職 臺北榮民總醫院復健醫學部神經復健科主任
國立陽明交通大學醫學系部定教授
專長 神經復健,腦中風復健,疼痛復健.
證照 復健醫學專科醫師
台灣老年醫學專科醫師

A.期刊論文:

  1. Pang-Wei Chang, Chia-Feng Lu, Shin-Tsu Chang, Po-Yi Tsai*. Functional Near-Infrared Spectroscopy as a Target Navigator for rTMS Modulation in Patients with Hemiplegia: A Randomized Control Study. Neurol Ther. 2021 Nov 13.doi:10.1007/s40120-021-00300-0 (IF=5.81, Q1) 通訊作者
  2. I-Ting Lee, Chu-Chung Huang, Po-Cheng Hsu, Ching-Po Lin, Po-Yi Tsai*. Resting-State Network Changes Following Transcranial Magnetic Stimulation in Patients with Aphasia- A Randomized Controlled Study. Neuromodulation: Technology at the Neural Interface. (IF=4.7, Q2) https://doi.org/10.1016/j.neurom.2021.10.004通訊作者
  3. Tsai-Chin Cheng, Shih-Fong Huang, Shang-Yu Wu, Fu-Gong Lin, Wang-Sheng Lin and Po-Yi Tsai* Integration of Virtual Reality intoTranscranial Magnetic Stimulation Improves Cognitive Function in Patients with Parkinson’s Disease with Cognitive Impairment: A Proof-of-Concept Study. Journal of Parkinson’s Disease. 2021 Dec 7. doi: 10.3233/JPD-212978.(IF=5.56, Q1)通訊作者
  4. Weijia He, J.-C.W., Po-Yi Tsai. Theta Burst Magnetic Stimulation Improves Parkinson’s-Related Cognitive Impairment: A Randomised Controlled Study. Neurorehabil Neural Repair. 2021 Nov;35(11):986-995.doi: 10.1177/1545968321104131 (IF=3.91, Q1). 通訊作者
  5. Po-Yi Tsai*, Wang-Sheng Lin, Kun-Ting Tsai, Chia-Yu Kuo, Pei-Hsin Lin. High-Frequency Versus Theta Burst Transcranial Magnetic Stimulation for the Treatment of Poststroke Cognitive Impairment in Humans. J Psychiatry &Neuroscience. 2020 Mar 11;45(3):262-270. ( IF=6.1, Q1 ) 通訊&第一作者
  6. Wang-Sheng Lin, Chen-Liang Chou, Miao-Hsiang Chang, Yuh-Mei Chung, Fu-Gong Lin, Po-Yi Tsai* Vagus Nerve Magnetic Modulation Facilitates Dysphagia Recovery in Patients with Stroke Involving the Brainstem - a proof of concept study. Brain Stimulation, 2018 Jan (11), 264-270 (IF=8.95, Q1)通訊作者
  7. Lai CJ, Wang CP, Tsai PY*, Chan RC, Lin SH, Lin FG, Hsieh CY. Corticospinal Integrity and Motor Impairment Predict Outcomes after Excitatory Repetitive Transcranial Magnetic Stimulation - a Preliminary Study. Arch Phys Med Rehabil. 2015 Jan; 96(1):69-75. (IF=3.9, REHABILITATION) 通訊作者
  8. Chih-Pin Wang, Chin-Yi Hsieh, Po-Yi Tsai*, Chia-To Wang, Fu-Gong Lin, Rai- Chi Chan. Efficacy of Synchronous Verbal Training during rTMS in Patients with Chronic Aphasia. Stroke 2014 Dec; 45(12):3656-62. (IF=7.9, 16/204) CLINICAL NEUROLOGY) 通訊作者
  9. Wen-Hsu Sung, Chih-Pin Wang, Chen-Liang Chou, Yi-Cheng Chen, Yue-Cune Chang, Po-Yi Tsai*. Efficacy of coupling inhibitory and facilitatory rTMS to enhance motor recovery in hemiplegic stroke patients. Stroke 2013 May; 44:1375-1382.( (IF=7.9, 16/204) CLINICAL NEUROLOGY) Nature Review, Neurology 2013, 9(5):240. doi:10.1038, Article highlight通訊作者
  10. Po-Yi Tsai*,Chih-Pin Wang; James S Ko,Yeh-Mei Chung, Ya-Wen Chang, Jian-Xiang Wang. The persistent and broadly modulating effect of inhibitory rTMS in non-fluent aphasic patients - a sham-controlled, double-blind study. Neurorehabilitation& Neural Repair 2014 Oct, 28:779-787 (IF:3.98 Rank:2/64, REHABILITATION) 復健領域第二名期刊,通訊第一作者
  11. Chih-Pin Wang ;Po-Yi Tsai* ;Tsui Fen Yang ; Kuang-Yao Yang; Chien-Chih Wang. Differential Effect of Conditioning Sequences in Coupling Inhibitory/Facilitatory rTMS for Post-stroke Motor Recovery. CNS: Neuroscience and Therapeutics 2014 Apr, 20:355-363. (IF=4.074, rank:43/254, PHARMACOLOGY & PHARMACY) 通訊作者
  12. Po-Yi Tsai, Chih-Pin Wang, Chin-Yi Hsieh, Yun-An Tsai, Shih-Ching Yeh, Tien-Yow Chuang*.Long-Term Sacral Magnetic Stimulation for Refractory Stress Urinary Incontinence. Arch Phys Med Rehabil. 2014 Dec;95(12):2231-8. (IF=3.09, Rank: 7/64, REHABILITATION) 第一作者
  13. Chien-Chih Wang, Chih-Pin Wang, Po-Yi Tsai*, Chin-Yi Hsieh, Rai-Chi Chan, Shih-Ching Yeh. Inhibitory Repetitive Transcranial Magnetic Stimulation of the Contralesional Premotor and Primary Motor Cortices Facilitate Poststroke Motor Recovery. Restor Neurol Neurosci. 2014 Mar, 32(6):825-35. (IF:2.496, Rank:153/252, NEUROSCIENCE) 通訊作者
  14. Jia-Yih Feng, Kuan-Ting Liu, Edward Abraham, Cheng-Yu Chen, Po-Yi Tsai, Yu-Chun Chen,Yu-Chin Lee, Kuang-Yao Yang. Serum Estradiol Levels Predict Survival and Acute Kidney Injury in Patients with Septic Shock- A Prospective Study. PLOS ONE, 2014 Jun; 9(6): e97967. (IF=3.234, Rank: 8/56)
  15. Shih-Ching Yeh, Ming-Chun Huang, Pa-Chun Wang, Te-Yung Fang, Mu-Chun Su, Po-Yi Tsai, Albert Rizzo. Machine learning-based assessment tool for imbalance and vestibular dysfunction with virtual reality rehabilitation system. Computer Methods and Programs in Biomedicine. 2014 Oct, 116(3):311-8 (14)00166-7. (IF=1.897, rank=17/102, COMPUTOR SCIENCE, THEORY AND METHOD)
  16. Shih-Ching Yeh, Shuya Chen, Pa-Chun Wang*, Mu-Chun Su, Chia-Huang Chang, Po-Yi Tsai, “Interactive 3-Dimensional Virtual Reality Rehabilitation for Patients with Chronic Imbalance and Vestibular Dysfunction”, Technology and Health Care, 2014, Jul, 22(6):915-21, (SCI, IF=0.697, 78/89, HEALTH CARE SCIENCE &SERVICES)
  17. Huang SF, Tsai YA, Wu SB, Wei YH, Tsai PY, Chuang TY. Effects of intravascular laser irradiation of blood in mitochondria dysfunction and oxidative stress in adults with chronic spinal cord injury. Photomed Laser Surg. 2012 Oct ;30(10):579-86. (IF=1.672, Rank=88/198, SURGERY).
  18. Chih-Pin Wang, Wen-Hsu Sung, Chien-Chih Wang, Po-Yi Tsai*. Early recognition of pelvic floor dyssynergia and colorectal assessment in Parkinson’s disease associated with bowel dysfunction. Colorectal Disease 2013 May; 15(3):, e130-7 (IF=2.351, Rank=57/198, SURGERY)
  19. Chih-Pin Wang, Po-Yi Tsai*. Efficacy of Spinal Magnetic Stimulation in Elderly Persons with Chronic Constipation. J Chin Med Asso 2012 Mar, 75(3):127-31.
  20. Chen-Ming Chiu, Chih-Pin Wang, Wen-Hsu Sung, Shih-Fong Huang, Shu-Chiung Chiang, Po-Yi Tsai*. Functional Magnetic Stimulation in Constipation Associated with Parkinson Disease. J Rehabil Med. 2009 Nov, 41(13): 1085-9. 通訊作者
  21. Po-Yi Tsai, Henrich Cheng, Wen-Cheng Huang, Ming-Chao Huang, Fang-Yao Chiu, Yue-Cune Chang, Tien-Yow Chuang*. Outcomes of common peroneal nerve lesions after surgical repair with aFGF. J Trauma, 2009 May, 66(5):1379-84.
  22. Po-Yi Tsai, Chih-Pin Wang, Yu-An Tsai, Fang-Yao Chiu, Yue-Cune Chang, Tien-Yow Chuang*. Efficacy of Functional Magnetic Stimulation in Neurogenic Bowel Dysfunction after Spinal Cord Injury. J Rehabil Med 2009 Jan;41:41-47.
  23. Shih-Fong Huang, Po-Yi Tsai, Wen-Hsu Sung, Chih-Yung Lin, Tien-Yow Chuang*. The Comparisons of Heart Rate Variability and Perceived Exertion During Simulated Cycling with Various Viewing Devices. Presence-Teleop Virt 2008; 17(6):575-583.
  24. Po- Yi Tsai, Tien-Yow Chuang*, Henrich Cheng, Hsiu-Mei Wu, Yue-Cune Chang. “The Concordance and Discrepancy between Electrodiagnosis and Magnetic Resonance Imaging in Cervical Root Avulsion Injuries.” J Neurotrauma, 2006; (23):1274-1281.

 

B.經顱磁刺激治療:

經顱磁刺激可重新開啟大腦功能:藥物治療有限,需要另一種新療法來達到治療效果。

利用經顱磁刺激治療(顱磁治療)的患者,除了有腦中風、阿茲海默症、失智症患者之外,像是年輕型的小腦萎縮症患者,對於腦部功能和肢體障礙均有明顯的改善。在治療腦中風、失智症以及高齡者的動作障礙、語言障礙、認知功能和吞嚥困難.....等方面,都有不錯的成效之外,目前也將經顱磁刺激運用在疼痛症候群患者身上,包括肌筋膜疼痛症、肌纖疼痛症、神經性疼痛以及術後疼痛等病症,患者對於疼痛的改善都有初步的成效。

此治療為物理性治療,無侵入性、不需手術,副作用少,治療過程中沒有痛苦,僅需配合兩週時間為一個療程,每個人做要做幾個療程則是因人而異。

藉由神經刺激和調控,幫助活化大腦功能

經顱磁刺激(rTMS)的機轉,是透過放在頭顱外的磁力線圈,經由電磁感應的原理,使大腦內部產生相對應的電流,這個電流可以去活化失去功能的大腦區域,進而幫助恢復大腦功能。

由於人類左右兩側的大腦是互相競爭的,健康側的大腦受損之後,非常容易過度活化進而阻礙患側功能的恢復,神經調控的治療就是透過調整腦部的活性,刺激剩餘的腦迴路得到重建,並開啟新的連結,以達到功能的恢復。

病人成果:

  1. 陳女士因阿茲海默症病患長期使用抗失智症藥物,仍然忘記所發生的事情,會去廚房說拿衣服,對於人事時地物容易混淆,接受一個療程顱磁治療以後,開始明顯進展,會有較合理的行為反應。
  2. 何女士,也因阿茲海默症長期困擾將近 10 年,本來是開朗好動的個性,目前只能夠坐在輪椅上,無法發表言語,最後也是接受顱磁治療兩個療程,講話變多,原本是木然對外界無反應,現在進步不但變得比較愛講話,對於外界的事物也有適當的反應,目前仍然持續進步中。
  3. 另一位患者因阿茲海默症病長期使用抗失智症藥物,但依舊會忘記發生過的事情,而且有時候會走去廚房說要拿衣服,對於人事時地物經常混淆;但在接受一個療程的經顱磁刺激術的治療後,這些反常的行為明顯改善許多。  

動靜脈畸形出血三次後接受rTMS治療,恢復行走功能 

  1. 中風癱瘓新療法 患者可恢復站立行走 2019年4月29日 公視
    https://www.youtube.com/watch?v=wI3obarEXBc

自由時報報導(文字及影音報導): 2021/03/01

  1. 失能拚恢復1》年輕人也可能中風! 熬夜、水喝太少風險高https://health.ltn.com.tw/article/breakingnews/3452511
  2. 失能拚恢復2》中風6年失語失能 經顱磁治療說出歌神名https://health.ltn.com.tw/article/breakingnews/3452510
  3. 失能拚恢復3》每天2小時助恢復 居家復健有訣竅https://health.ltn.com.tw/article/breakingnews/3452509

文字報導:

  1. 中風失語兩年 rTMS療法30天他重新開口說話 2019-03-09 聯合報https://health.udn.com/health/story/5999/3687404
  2. 經顱磁刺激協助失智者奪回話語權,讓大腦重新開機https://www.ttvc.com.tw/smart-medical/%E7%B6%93%E9%A1%B1%E7%A3%81%E5%88%BA%E6%BF%80%E5%8D%94%E5%8A%A9%E5%A4%B1%E6%99%BA%E8%80%85%E5%A5%AA%E5%9B%9E%E8%A9%B1%E8%AA%9E%E6%AC%8A-%E8%AE%93%E5%A4%A7%E8%85%A6%E9%87%8D%E6%96%B0%E9%96%8B%E6%A9%9F-a-16647.html
  3. 失智症有救了?北榮研究發現:經顱磁刺激可重新開啟大腦功能 - Heho健康
    https://heho.com.tw/archives/198101

經顱磁刺激 居家復健動作教學:

https://youtu.be/iStYjqN20pA

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