Pavlova Elena L, Lindberg Påvel, Khan Amirah, Ruschkowski Sigurd, Nitsche Michael A, Borg Jörgen
Department of Clinical Sciences Karolinska Institute, Danderyd University Hospital, Stockholm, Sweden.
Centre de Psychiatrie et Neurosciences, INSERM U894, Paris, France.
Restor Neurol Neurosci. 2017;35(3):307-317. doi: 10.3233/RNN-160706.
Recent studies exploring the combined effect of motor learning and transcranial direct current stimulation (tDCS) for stroke rehabilitation have shown partially conflicting results.
To test the efficacy of an optimized hand training approach combined with tDCS in stroke patients.
In the present pilot study we investigated motor effects of four-week training with a visuomotor grip force tracking task combined with tDCS in 11 chronic stroke patients. Anodal (0.5 mA) or sham tDCS was applied over the primary motor cortex of the lesioned side for 20 minutes, twice a day, during training.
No difference between the Active and Sham groups in the total upper extremity (UE) Fugl-Meyer Assessment (FMA) score was found. The most prominent recovery occurred in the shoulder-elbow FMA sub-score; in this segment a significantly greater improvement in the Active compared to the Sham group was observed up to two months after the intervention. Mean hold force during the first treatment session predicted the change in the total UE FMA score after treatment.
Four-week visuo-motor training combined with tDCS showed no difference between the Active and Sham groups in the total UE FMA score, which may be explained by heterogeneity of the degree of recovery in the Active group. However, the shoulder-elbow FMA sub-score improved significantly more in the Active compared to the Sham group, which deserves further study.
近期探索运动学习与经颅直流电刺激（tDCS）联合用于中风康复的研究结果存在部分冲突。
测试优化的手部训练方法联合tDCS对中风患者的疗效。
在本初步研究中，我们调查了11例慢性中风患者进行为期四周的视觉运动握力跟踪任务联合tDCS训练的运动效果。训练期间，阳极（0.5毫安）或伪tDCS施加于患侧初级运动皮层，每次20分钟，每天两次。
主动组和伪刺激组在上肢Fugl-Meyer评估（FMA）总分上未发现差异。最显著的恢复发生在肩-肘FMA子评分中；在该节段，与伪刺激组相比，主动组在干预后长达两个月时观察到显著更大的改善。首次治疗期间的平均握力可预测治疗后上肢FMA总分的变化。
四周的视觉运动训练联合tDCS在主动组和伪刺激组的上肢FMA总分上未显示差异，这可能是由于主动组恢复程度的异质性所致。然而，与伪刺激组相比，主动组的肩-肘FMA子评分改善更为显著，值得进一步研究。
