Yi You Gyoung, Chun Min Ho, Do Kyung Hee, Sung Eun Jung, Kwon Yong Gyu, Kim Dae Yul
Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ann Rehabil Med. 2016 Apr;40(2):223-9. doi: 10.5535/arm.2016.40.2.223. Epub 2016 Apr 25.
To examine whether transcranial direct current stimulation (tDCS) applied over the posterior parietal cortex (PPC) improves visuospatial attention in stroke patients with left visuospatial neglect.
Patients were randomly assigned to 1 of 3 treatment groups: anodal tDCS over the right PPC, cathodal tDCS over the left PPC, or sham tDCS. Each patient underwent 15 sessions of tDCS (5 sessions per week for 3 weeks; 2 mA for 30 minutes in each session). Outcome measures were assessed before treatment and 1 week after completing the treatment.
From pre- to post-treatment, there was an improvement in the motor-free visual perception test (MVPT), line bisection test (LBT), star cancellation test (SCT), Catherine Bergego Scale (CBS), Korean version of Modified Barthel Index (K-MBI), and Functional Ambulation Classification in all 3 groups. Improvements in the MVPT, SCT, and LBT were greater in the anodal and cathodal groups than in the sham group. However, improvements in other outcomes were not significantly different between the 3 groups, although there was a tendency for improved CBS or K-MBI scores in the anodal and cathodal groups, as compared with the sham group.
The study results indicated that the facilitatory effect of anodal tDCS applied over the right PPC, and the inhibitory effect of cathodal tDCS applied over the left PPC, improved symptoms of visuospatial neglect. Thus, tDCS could be a successful adjuvant therapeutic modality to recover neglect symptom, but this recovery might not lead to improvements in activities of daily living function and gait function.
探讨经颅直流电刺激(tDCS)作用于顶叶后皮质(PPC)是否能改善存在左侧视觉空间忽视的中风患者的视觉空间注意力。
将患者随机分为3个治疗组之一:右侧PPC进行阳极tDCS、左侧PPC进行阴极tDCS或假tDCS。每位患者接受15次tDCS治疗(每周5次,共3周;每次治疗2 mA,持续30分钟)。在治疗前和完成治疗1周后评估结果指标。
从治疗前到治疗后,所有3组患者在无运动视觉感知测试(MVPT)、直线二等分测试(LBT)、星形删除测试(SCT)、凯瑟琳·贝热戈量表(CBS)、韩国版改良巴氏指数(K-MBI)和功能性步行分类方面均有改善。阳极和阴极组在MVPT、SCT和LBT方面的改善大于假刺激组。然而,3组在其他结果方面的改善没有显著差异,尽管与假刺激组相比,阳极和阴极组的CBS或K-MBI评分有改善的趋势。
研究结果表明,右侧PPC应用阳极tDCS的促进作用以及左侧PPC应用阴极tDCS的抑制作用改善了视觉空间忽视症状。因此,tDCS可能是恢复忽视症状的一种成功辅助治疗方式,但这种恢复可能不会导致日常生活功能和步态功能的改善。