Rosset-Llobet Jaume, Fàbregas-Molas Sílvia, Pascual-Leone Álvaro
Institut de Fisiologia i Medicina de l'Art-Terrassa, Ctra. de Montcada 668, 08222 Terrassa (Barcelona), Spain. Tel +34937844775.
Med Probl Perform Art. 2015 Sep;30(3):178-84. doi: 10.21091/mppa.2015.3033.
Task-specific focal hand dystonia can disable affected individuals. Although neurorehabilitation techniques such as sensory motor retuning can result in complete recovery in some patients, it requires many months of treatment. Combining transcranial direct current stimulation (tDCS) with neurorehabilitation is a new and promising approach that can help these patients. However, the results in different studies are contradictory.
Analyze whether delivering tDCS (cathode over left and anode over right parietal region) during the neurorehabilitation process for musicians with dystonia can increase the effectiveness of therapy.
A parallel double-blind randomized design was used to study 30 musicians with right-hand primary focal dystonia. All patients underwent a 2-week course of neurorehabilitation based on sensory motor retuning therapy coupled with either real or sham tDCS for the first 30 minutes of each daily 1-hour therapy session (total 10 sessions). The therapist and patient were blind to the tDCS condition. A dystonia severity score was obtained before and after the 2-week protocol. The therapist also rated the evolution of each patient.
Both groups significantly improved their dystonia severity score during the 2 weeks. Score differences were 88.23 (±40.51) and 63.36 (±30.57) for the active and sham groups, respectively. The active group showed a statistically significant greater improvement.
Biparietal tDCS with left-sided cathode is a safe technique that does not interfere with the neurorehabilitation procedure and can increase therapy effectiveness in rehabilitation patients with right-hand task-specific focal dystonia.
特定任务性局灶性手部肌张力障碍会使受影响个体致残。尽管诸如感觉运动重新训练等神经康复技术能使部分患者完全康复,但这需要数月的治疗。将经颅直流电刺激(tDCS)与神经康复相结合是一种新的且有前景的方法,可帮助这些患者。然而,不同研究的结果相互矛盾。
分析在肌张力障碍音乐家的神经康复过程中给予tDCS(阴极置于左侧顶叶区域,阳极置于右侧顶叶区域)是否能提高治疗效果。
采用平行双盲随机设计,对30名右手原发性局灶性肌张力障碍的音乐家进行研究。所有患者均接受基于感觉运动重新训练疗法的为期2周的神经康复课程,在每天1小时的治疗课程的前30分钟,结合真实或 sham tDCS(共10次治疗)。治疗师和患者对tDCS情况不知情。在2周方案前后获得肌张力障碍严重程度评分。治疗师也对每位患者的进展进行评分。
两组在2周内肌张力障碍严重程度评分均显著改善。主动治疗组和 sham 治疗组的评分差异分别为88.23(±40.51)和63.36(±30.57)。主动治疗组显示出统计学上更显著的改善。
左侧阴极的双侧顶叶tDCS是一种安全的技术,不干扰神经康复过程,并且可以提高右手特定任务性局灶性肌张力障碍康复患者的治疗效果。