Department of Neurology, University of California, San Francisco, USA.
Neurology & Rehabilitation Service, San Francisco VA Medical Center, 1700 Owens Street, San Francisco, California, 94158, USA.
J Neuroeng Rehabil. 2017 Nov 13;14(1):113. doi: 10.1186/s12984-017-0323-1.
Few patients recover full hand dexterity after an acquired brain injury such as stroke. Repetitive somatosensory electrical stimulation (SES) is a promising method to promote recovery of hand function. However, studies using SES have largely focused on gross motor function; it remains unclear if it can modulate distal hand functions such as finger individuation.
The specific goal of this study was to monitor the effects of SES on individuation as well as on cortical oscillations measured using EEG, with the additional goal of identifying neurophysiological biomarkers.
Eight participants with a history of acquired brain injury and distal upper limb motor impairments received a single two-hour session of SES using transcutaneous electrical nerve stimulation. Pre- and post-intervention assessments consisted of the Action Research Arm Test (ARAT), finger fractionation, pinch force, and the modified Ashworth scale (MAS), along with resting-state EEG monitoring.
SES was associated with significant improvements in ARAT, MAS and finger fractionation. Moreover, SES was associated with a decrease in low frequency (0.9-4 Hz delta) ipsilesional parietomotor EEG power. Interestingly, changes in ipsilesional motor theta (4.8-7.9 Hz) and alpha (8.8-11.7 Hz) power were significantly correlated with finger fractionation improvements when using a multivariate model.
We show the positive effects of SES on finger individuation and identify cortical oscillations that may be important electrophysiological biomarkers of individual responsiveness to SES. These biomarkers can be potential targets when customizing SES parameters to individuals with hand dexterity deficits.
NCT03176550; retrospectively registered.
少数患者在脑损伤（如中风）后能完全恢复手部灵巧度。重复体感电刺激（SES）是促进手部功能恢复的一种很有前途的方法。然而，使用 SES 的研究主要集中在运动功能上；尚不清楚它是否可以调节手指个体化等远端手部功能。
本研究的具体目标是监测 SES 对手部个体化以及脑电图（EEG）测量的皮质振荡的影响，并确定神经生理生物标志物。
8 名有脑损伤和远端上肢运动障碍病史的参与者接受了单次 2 小时的经皮神经电刺激 SES 治疗。干预前后评估包括动作研究上肢测试（ARAT）、手指分割、捏力和改良 Ashworth 量表（MAS），以及静息状态 EEG 监测。
SES 与 ARAT、MAS 和手指分割的显著改善相关。此外，SES 与同侧顶叶运动 EEG 功率的低频（0.9-4 Hz 德尔塔）降低相关。有趣的是，使用多变量模型时，同侧运动θ（4.8-7.9 Hz）和α（8.8-11.7 Hz）功率的变化与手指分割改善显著相关。
我们展示了 SES 对手指个体化的积极影响，并确定了皮质振荡可能是个体对 SES 反应的重要电生理生物标志物。这些生物标志物可能是在手灵巧度缺陷患者中定制 SES 参数的潜在目标。
NCT03176550；回顾性注册。
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