经颅多普勒研究：脑卒中后脑血流调节的非侵入性脑刺激的系统评价。
Non-invasive brain stimulation in the modulation of cerebral blood flow after stroke: A systematic review of Transcranial Doppler studies.
机构信息
Graduate Program in Rehabilitation Science, College of Applied Health Sciences, University of Illinois, Chicago, IL, USA; Brain Plasticity Laboratory, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL, USA.
Brain Plasticity Laboratory, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL, USA.
出版信息
Clin Neurophysiol. 2018 Dec;129(12):2544-2551. doi: 10.1016/j.clinph.2018.09.019. Epub 2018 Oct 25.
OBJECTIVE
Non-invasive brain stimulation (NIBS), such as repetitive TMS (rTMS) and transcranial direct current stimulation (tDCS), are promising neuromodulatory priming techniques to promote task-specific functional recovery after stroke. Despite promising results, clinical application of NIBS has been limited by high inter-individual variability. We propose that there is a possible influence of neuromodulation on cerebral blood flow (CBF), as neurons are spatially and temporally related to blood vessels. Transcranial Doppler (TCD), a clinically available non-invasive diagnostic tool, allows for evaluation of CBF velocity (CBFv). However, little is known about the role of neuromodulation on CBFv.
METHODS
A systematic review of literature to understand the effects of NIBS on CBFv using TCD in stroke was conducted.
RESULTS
Twelve studies fit our inclusion criteria and are included in this review. Our review suggested that CBFv and/or vasomotor reactivity maybe influenced by rTMS dosage (intensity and frequency) and the type of tDCS electrode montage.
CONCLUSION
There is limited evidence regarding the effects of NIBS on cerebral hemodynamics using TCD and the usefulness of TCD to capture changes in CBFv after NIBS is not evident from this review. We highlight the variability in the experimental protocols, differences in the applied neurostimulation protocols and discuss open questions that remain regarding CBF and neuromodulation.
SIGNIFICANCE
TCD, a clinically accessible tool, may potentially be useful to understand the interaction between cortical neuromodulation and CBFv.
目的
非侵入性脑刺激（NIBS），如重复经颅磁刺激（rTMS）和经颅直流电刺激（tDCS），是有前途的神经调节启动技术，可以促进中风后的特定任务功能恢复。尽管有很有前景的结果，但 NIBS 的临床应用受到个体间差异的限制。我们提出，神经元在空间和时间上与血管有关，因此神经调节可能对脑血流（CBF）有影响。经颅多普勒（TCD）是一种临床可用的非侵入性诊断工具，可用于评估脑血流速度（CBFv）。然而，关于神经调节对 CBFv 的影响知之甚少。
方法
对使用 TCD 评估 NIBS 对中风患者 CBFv 的影响进行了系统的文献综述。
结果
有 12 项研究符合我们的纳入标准，并包括在本综述中。我们的综述表明，rTMS 剂量（强度和频率）和 tDCS 电极放置方式可能会影响 CBFv 和/或血管运动反应性。
结论
使用 TCD 评估 NIBS 对脑血流动力学的影响的证据有限，并且 TCD 捕捉 NIBS 后 CBFv 变化的有用性在本综述中并不明显。我们强调了实验方案的可变性、应用的神经刺激方案的差异，并讨论了关于 CBF 和神经调节的未解决问题。
意义
TCD 是一种临床可获得的工具，可能有助于理解皮质神经调节和 CBFv 之间的相互作用。
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