Institute of Medical Psychology, Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.
Restor Neurol Neurosci. 2010;28(6):825-33. doi: 10.3233/RNN-2010-0580.
Recovery of post-stroke deficits can be achieved by modulating neuroplasticity with non-invasive brain stimulation. To evaluate potential effects of repetitive transorbital alternating current stimulation (rtACS) on stroke recovery we carried out a randomized, drug-controlled clinical trial.
Ninety-eight patients that had suffered ischemic stroke 21.4 months earlier were randomly assigned to either group D (n=30) receiving conventional drug therapy, group ACS (n=32) treated for 12 days with rtACS, or group D/ACS (n=36) receiving combined drug therapy/rtACS. Stroke severity level (SSL) was assessed by the NIH-NINDS stroke scale before and after treatment and at a 1-month follow-up to evaluate motor impairments (weakness, ataxia), sensory loss, visual field defects, and cortical deficits (aphasia, neglect). At each time point standard EEG recordings (10-20 system) were conducted.
Before therapy SSL was moderate (9.18 ± 0.78) without significant group difference (F =0.86, p=0.43). After 12 days of treatment, SSLs of groups ACS and D/ACS significantly improved by 22.5% and 25.1% over baseline, respectively, with no such change in the control group D (+3%). SSL improvements were mainly due to recovery of motor, sensory, and speech functions. After 1-month follow-up, an additional improvement of 9.7% and 9.4% was seen for the group ACS and D/ACS which led to a total change of +32.3% and +34.7% over baseline. EEG recordings revealed greater interhemispheric synchrony between both temporal lobes which were positively correlated with clinical outcome.
Non-invasive rtACS applied to post-stroke patients can modulate brain plasticity and induce recovery from neurological deficits long after the early post lesion recovery is over.
通过非侵入性脑刺激调节神经可塑性，可以实现中风后的恢复。为了评估重复经颅交流电刺激（rtACS）对中风恢复的潜在影响，我们进行了一项随机、药物对照的临床试验。
98 名缺血性中风后 21.4 个月的患者被随机分为 3 组：药物治疗组（D 组，n=30）、rtACS 治疗组（ACS 组，n=32）和联合药物/rtACS 治疗组（D/ACS 组，n=36）。治疗前后及 1 个月随访时，采用 NIH-NINDS 中风量表评估中风严重程度（SSL），以评估运动障碍（无力、共济失调）、感觉丧失、视野缺损和皮质缺陷（失语、忽视）。在每个时间点进行标准脑电图（10-20 系统）记录。
治疗前，SSL 为中度（9.18±0.78），组间无显著差异（F=0.86，p=0.43）。治疗 12 天后，ACS 组和 D/ACS 组的 SSL 分别较基线改善 22.5%和 25.1%，而对照组 D 组无改善（+3%）。SSL 的改善主要归因于运动、感觉和言语功能的恢复。1 个月随访时，ACS 组和 D/ACS 组的 SSL 分别再改善 9.7%和 9.4%，与基线相比，总改善率分别为+32.3%和+34.7%。脑电图记录显示，两侧颞叶之间的半球间同步性增加，与临床结果呈正相关。
应用于中风后患者的非侵入性 rtACS 可以调节大脑的可塑性，并在早期损伤后恢复结束后很长时间内诱导神经功能缺损的恢复。
