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经颅直流电刺激患侧半球不会加速急性脑卒中患者的康复。

Transcranial direct current stimulation of the affected hemisphere does not accelerate recovery of acute stroke patients.

机构信息

Stroke Unit, University of Tor Vergata, Rome Fondazione Santa Lucia IRCCS, Rome, Italy.

出版信息

Eur J Neurol. 2013 Jan;20(1):202-4. doi: 10.1111/j.1468-1331.2012.03703.x. Epub 2012 Mar 26.

Abstract

BACKGROUND AND PURPOSE

Transcranial direct current stimulation (TDCS) is a potential tool to improve motor deficits in chronic stroke patients. Safety and efficacy of this procedure in acute stroke patients have not yet been addressed.

METHODS

We performed in our stroke unit a single-centre randomized, double-blind, sham-controlled study to investigate safety and efficacy of anodal TDCS of the affected hemisphere in acute stroke patients. The second day from stroke onset, 50 acute stroke patients received either five-daily sessions of anodal (n=25) at 2mA for 20min or sham TDCS (n=25) to the ipsilesional primary motor cortex (M1). Motor deficit was assessed by the short form of the Fugl-Meyer motor scale (FM) and overall neurological deficit by the National Institute of Health Stroke Scale (NIHSS) at onset, at 5days after stroke and after 3months.

RESULTS

No side effects were detected during either TDCS or sham. In both groups, there was a significant improvement in NIHSS and FM scores, which did not significantly differ when comparing TDCS and sham.

CONCLUSIONS

Five-daily sessions of anodal TDCS to the ipsilesional M1 appear to be safe in acute stroke patients but do not improve clinical outcome.

摘要

背景与目的

经颅直流电刺激(TDCS)是一种有潜力的工具,可以改善慢性中风患者的运动障碍。但其在急性中风患者中的安全性和疗效尚未得到解决。

方法

我们在卒中单元进行了一项单中心、随机、双盲、假刺激对照研究,以调查急性中风患者对患侧半球进行阳极 TDCS 的安全性和疗效。从中风发作后的第二天开始,50 名急性中风患者接受了 5 次每日的治疗,其中 25 名接受了 2mA 的阳极刺激(20 分钟),25 名接受了假刺激,刺激部位为同侧初级运动皮层(M1)。运动缺陷采用 Fugl-Meyer 运动量表(FM)的简短形式,神经功能缺损采用国立卫生研究院卒中量表(NIHSS)在发病时、中风后 5 天和 3 个月进行评估。

结果

无论是 TDCS 还是假刺激,都没有发现副作用。两组 NIHSS 和 FM 评分均有显著改善,且 TDCS 与假刺激组之间无显著差异。

结论

每日对同侧 M1 进行 5 次阳极 TDCS 似乎在急性中风患者中是安全的,但不能改善临床结局。

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