Fan Julie, Voisin Julien, Milot Marie-Hélène, Higgins Johanne, Boudrias Marie-Hélène
School of physical & occupational therapy, faculty of medicine, McGill university, Montréal, Canada.
Département de réadaptation, faculté de médecine, université Laval, Québec, Canada; Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada.
Ann Phys Rehabil Med. 2017 Sep;60(5):329-333. doi: 10.1016/j.rehab.2017.07.001. Epub 2017 Aug 7.
Recovery of handgrip is critical after stroke since it is positively related to upper limb function. To boost motor recovery, transcranial direct current stimulation (tDCS) is a promising, non-invasive brain stimulation technique for the rehabilitation of persons with stroke. When applied over the primary motor cortex (M1), tDCS has been shown to modulate neural processes involved in motor learning. However, no studies have looked at the impact of tDCS on the learning of a grip task in both stroke and healthy individuals.
To assess the use of tDCS over multiple days to promote motor learning of a grip task using a learning paradigm involving a speed-accuracy tradeoff in healthy individuals.
In a double-blinded experiment, 30 right-handed subjects (mean age: 22.1±3.3 years) participated in the study and were randomly assigned to an anodal (n=15) or sham (n=15) stimulation group. First, subjects performed the grip task with their dominant hand while following the pace of a metronome. Afterwards, subjects trained on the task, at their own pace, over 5 consecutive days while receiving sham or anodal tDCS over M1. After training, subjects performed de novo the metronome-assisted task. The change in performance between the pre and post metronome-assisted task was used to assess the impact of the grip task and tDCS on learning.
Anodal tDCS over M1 had a significant effect on the speed-accuracy tradeoff function. The anodal tDCS group showed significantly greater improvement in performance (39.28±15.92%) than the sham tDCS group (24.06±16.35%) on the metronome-assisted task, t(28)=2.583, P=0.015 (effect size d=0.94).
Anodal tDCS is effective in promoting grip motor learning in healthy individuals. Further studies are warranted to test its potential use for the rehabilitation of fine motor skills in stroke patients.
中风后手抓握功能的恢复至关重要,因为它与上肢功能呈正相关。为促进运动功能恢复,经颅直流电刺激(tDCS)是一种有前景的、用于中风患者康复的非侵入性脑刺激技术。当应用于初级运动皮层(M1)时,tDCS已被证明可调节参与运动学习的神经过程。然而,尚无研究探讨tDCS对中风患者和健康个体抓握任务学习的影响。
使用涉及速度 - 准确性权衡的学习范式,评估多日应用tDCS对健康个体抓握任务运动学习的促进作用。
在一项双盲实验中,30名右利手受试者(平均年龄:22.1±3.3岁)参与研究,并被随机分配至阳极(n = 15)或假刺激(n = 15)组。首先,受试者在跟随节拍器节奏的同时用优势手执行抓握任务。之后,受试者在5天内按照自己的节奏进行该任务训练,同时接受M1区域的假刺激或阳极tDCS。训练后,受试者重新进行节拍器辅助任务。节拍器辅助任务前后的表现变化用于评估抓握任务和tDCS对学习的影响。
M1区域的阳极tDCS对速度 - 准确性权衡功能有显著影响。在节拍器辅助任务中,阳极tDCS组的表现改善(39.28±15.92%)显著大于假刺激tDCS组(24.06±16.35%),t(28)=2.583,P = 0.015(效应量d = 0.94)。
阳极tDCS可有效促进健康个体的抓握运动学习。有必要进一步研究其在中风患者精细运动技能康复中的潜在应用。