Department of Physical and Rehabilitation Medicine, Stroke and Cerebrovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
Neurosci Lett. 2013 Oct 25;554:94-8. doi: 10.1016/j.neulet.2013.08.064. Epub 2013 Sep 8.
Based on the interhemispheric inhibition model of unilateral visuospatial neglect (USN) after stroke, the effects of dual-mode transcranial direct current stimulation (tDCS) over the parietal cortices were assessed in a double-blind random-order cross-over experiment. Ten chronic right hemispheric stroke patients (4 men; mean age: 62.6 years) with USN were recruited. All participants underwent three randomly arranged tDCS sessions: (1) dual-mode, anodal tDCS over the right posterior parietal cortex (PPC) and cathodal tDCS over the left PPC; (2) single-mode, anodal tDCS over the right PPC; and (3) sham mode. Each session lasted 20min. Before and immediately after the stimulation, a line bisection test and star cancelation test were carried out. In the line bisection test, significant improvements were observed after both the dual- and the single-mode tDCS (p<0.05), but not after sham stimulation. Statistical analysis showed a significant interaction between time and tDCS mode, where the dual tDCS had a stronger effect than the single or sham stimulation modes (p<0.05). The star cancelation test did not show any significant change. These results suggest that dual tDCS over the bilateral PPC is an effective method for the treatment of USN in stroke patients.
基于脑卒中后单侧空间忽略(USN)的大脑两半球间抑制模型,本研究采用双盲随机交叉实验设计评估了经颅直流电刺激(tDCS)对顶叶皮质的双重模式的影响。招募了 10 名患有 USN 的慢性右侧半球脑卒中患者(4 名男性;平均年龄:62.6 岁)。所有参与者均接受了三种随机排列的 tDCS 治疗:(1)双重模式,即右侧顶叶皮质(PPC)的阳极 tDCS 和左侧 PPC 的阴极 tDCS;(2)单一模式,即右侧 PPC 的阳极 tDCS;(3)假刺激模式。每个疗程持续 20 分钟。在刺激之前和之后立即进行了直线二分测试和星号消除测试。在直线二分测试中,双重和单一模式 tDCS 后均观察到显著改善(p<0.05),但假刺激后没有观察到改善。统计分析显示时间和 tDCS 模式之间存在显著的交互作用,双重 tDCS 的效果强于单一或假刺激模式(p<0.05)。星号消除测试没有显示出任何显著变化。这些结果表明,双侧 PPC 的双重 tDCS 是治疗脑卒中患者 USN 的有效方法。