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经颅直流电刺激(tDCS)对胼胝体及半球内脑连接性的调节作用:对失语症干预的启示

Modulating transcallosal and intra-hemispheric brain connectivity with tDCS: Implications for interventions in Aphasia.

作者信息

Zheng Xin, Dai Weiying, Alsop David C, Schlaug Gottfried

机构信息

Department of Neurology, Neuroimaging and Stroke Recovery Laboratory, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.

Division of MR Research, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.

出版信息

Restor Neurol Neurosci. 2016 Jul 25;34(4):519-30. doi: 10.3233/RNN-150625.

Abstract

BACKGROUND/OBJECTIVE: Transcranial direct current stimulation (tDCS) can enhance or diminish cortical excitability levels depending on the polarity of the stimulation. One application of non-invasive brain-stimulation has been to modulate a possible inter-hemispheric disinhibition after a stroke. This disinhibition model has been developed mainly for the upper extremity motor system, but it is not known whether the language/speech-motor system shows a similar inter-hemispheric interaction. We aimed to examine physiological evidence of inter- and intra-hemispheric connectivity changes induced by tDCS of the right inferior frontal gyrus (IFG) using arterial-spin labeling (ASL) MRI.

METHODS

Using an MR-compatible DC-Stimulator, we applied anodal stimulation to the right IFG region of nine healthy adults while undergoing non-invasive cerebral blood flow imaging with arterial-spin labeling (ASL) before, during, and after the stimulation. All ASL images were then normalized and timecourses were extracted in regions of interest (ROIs), which were the left and right IFG regions, and the right supramarginal gyrus (SMG) in the inferior parietal lobule. Two additional ROIs (the right occipital lobe and the left fronto-orbital region) were taken as control regions.

RESULTS

Using regional correlation coefficients as a surrogate marker of connectivity, we could show that inter-hemispheric connectivity (right IFG with left IFG) decreased significantly (p < 0.05; r-scores from 0.67 to 0.53) between baseline and post-stimulation, while the intra-hemispheric connectivity (right IFG with right SMG) increased significantly (p < 0.05;r-scores from 0.74 to 0.81). A 2 × 2 ANOVA found a significant main effect of HEMISPHERE (F(8) = 6.83, p < 0.01) and a significant HEMISPHERE-by-TIME interaction (F(8) = 4.24, p < 0.05) in connectivity changes. The correlation scores did not change significantly in the control region pairs (right IFG with right occipital and right IFG with left fronto-orbital) over time.

CONCLUSION

Using an MR-compatible DC stimulator we showed that ASL-MRI can detect tDCS-induced modulation of brain connectivity within and between hemispheres. These findings might affect trial designs focusing on modulating the non-dominant hemisphere to enhance language/speech-motor functions.

摘要

背景/目的:经颅直流电刺激(tDCS)可根据刺激的极性增强或降低皮质兴奋性水平。非侵入性脑刺激的一种应用是调节中风后可能存在的半球间去抑制。这种去抑制模型主要是针对上肢运动系统建立的,但尚不清楚语言/言语运动系统是否表现出类似的半球间相互作用。我们旨在使用动脉自旋标记(ASL)MRI检查右额下回(IFG)经tDCS诱导的半球间和半球内连接性变化的生理证据。

方法

我们使用一台与磁共振兼容的直流刺激器,对9名健康成年人的右侧IFG区域施加阳极刺激,同时在刺激前、刺激期间和刺激后使用动脉自旋标记(ASL)进行非侵入性脑血流成像。然后对所有ASL图像进行归一化处理,并在感兴趣区域(ROI)提取时间序列,这些区域包括左侧和右侧IFG区域以及顶下小叶的右侧缘上回(SMG)。另外选取两个ROI(右侧枕叶和左侧额眶区域)作为对照区域。

结果

使用区域相关系数作为连接性的替代指标,我们发现半球间连接性(右侧IFG与左侧IFG)在基线和刺激后显著降低(p<0.05;r值从0.67降至0.53),而半球内连接性(右侧IFG与右侧SMG)显著增加(p<0.05;r值从0.74升至0.81)。一项2×2方差分析发现,在连接性变化方面,半球(F(8)=6.83,p<0.01)和半球×时间交互作用(F(8)=4.24,p<0.05)具有显著的主效应。随着时间推移,对照区域对(右侧IFG与右侧枕叶以及右侧IFG与左侧额眶)的相关分数没有显著变化。

结论

使用与磁共振兼容的直流刺激器,我们表明ASL-MRI能够检测到tDCS诱导的半球内和半球间脑连接性的调节。这些发现可能会影响专注于调节非优势半球以增强语言/言语运动功能的试验设计。

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