Ulam F, Shelton C, Richards L, Davis L, Hunter B, Fregni F, Higgins K
Missouri Rehabilitation Center, University of Missouri Health System, USA.
Missouri Rehabilitation Center, University of Missouri Health System, USA.
Clin Neurophysiol. 2015 Mar;126(3):486-96. doi: 10.1016/j.clinph.2014.05.015. Epub 2014 Jun 2.
To investigate in a randomized, double-blind design, cumulative effects of anodal tDCS on EEG oscillations and neuropsychological tests among patients with traumatic brain injury (TBI) undergoing subacute neurorehabilitation.
Twenty-six patients were randomly assigned to active (n=13) or sham (n=13) tDCS groups. EEGs were recorded at 6 different time points, assessing both immediate and cumulative effects of tDCS on EEG oscillations. Twenty minute sessions of 1mA anodal stimulation to the left dorsolateral prefrontal cortex (F3, cathode placed at right supraorbital site, Fp2), were provided on 10 consecutive days. Neuropsychological tests were administered before and after the series of tDCS sessions.
Theta was significantly reduced for active tDCS patients following the first tDCS session. Delta decreased and alpha increased, both significantly, for the active tDCS group after 10 consecutive tDCS sessions. No significant changes were seen for sham group. Decreases in delta were significantly correlated with improved performance on neuropsychological tests for the active tDCS group to far greater degree than for the sham group. Participants in the active tDCS group who had excess slow EEG activity in their initial recordings showed greater improvement on neuropsychological tests than other groups.
Results suggest that 10 anodal tDCS sessions may beneficially modulate regulation of cortical excitability for patients with TBI.
EEG-guided tDCS warrants further investigation as a potential intervention for TBI during subacute neurorehabilitation.
采用随机双盲设计,研究阳极经颅直流电刺激(tDCS)对正在接受亚急性神经康复治疗的创伤性脑损伤(TBI)患者脑电图振荡和神经心理测试的累积效应。
26例患者被随机分为活性tDCS组(n = 13)和假刺激tDCS组(n = 13)。在6个不同时间点记录脑电图,评估tDCS对脑电图振荡的即时和累积效应。连续10天,每天对左侧背外侧前额叶皮质(F3,阴极置于右侧眶上部位Fp2)进行20分钟的1mA阳极刺激。在一系列tDCS治疗前后进行神经心理测试。
首次tDCS治疗后,活性tDCS组患者的θ波显著降低。连续10次tDCS治疗后,活性tDCS组的δ波降低,α波升高,均具有显著性。假刺激组未见显著变化。活性tDCS组δ波的降低与神经心理测试成绩的改善显著相关,且程度远大于假刺激组。初始记录中脑电图慢波活动过多的活性tDCS组参与者在神经心理测试中的改善程度高于其他组。
结果表明,10次阳极tDCS治疗可能对TBI患者有益地调节皮质兴奋性。
脑电图引导的tDCS作为TBI亚急性神经康复期间的一种潜在干预措施,值得进一步研究。