经颅直流电刺激在脑卒中后失语症康复中的应用：系统评价。
Transcranial direct current stimulation in post-stroke aphasia rehabilitation: A systematic review.
机构信息
EA4136 handicap activity cognition health, university of Bordeaux, 33000 Bordeaux, France; Institut universitaire des sciences de la réadaptation, university of Bordeaux, 33000 Bordeaux, France.
EA4136 handicap activity cognition health, university of Bordeaux, 33000 Bordeaux, France; Department of physical medicine and rehabilitation, CHU de Bordeaux, 33000 Bordeaux, France.
出版信息
Ann Phys Rehabil Med. 2019 Mar;62(2):104-121. doi: 10.1016/j.rehab.2019.01.003. Epub 2019 Jan 17.
BACKGROUND
Transcranial direct current stimulation (tDCS) is a non-invasive tool that induces neuromodulation in the brain. Several studies have shown the effectiveness of tDCS in improving language recovery in post-stroke aphasia. However, this innovative technique is not currently used in routine speech and language therapy (SLT) practice.
OBJECTIVE
This systematic review aimed to summarise the role of tDCS in aphasia rehabilitation.
METHODS
We searched MEDLINE via PubMed and Scopus on October 5, 2018 for English articles published from 1996 to 2018. Eligible studies involved post-stroke aphasia rehabilitation with tDCS combined or not with SLT.
RESULTS
We retained 5 meta-analyses and 48 studies. Among the 48 studies, 39 were randomised controlled trials (558 patients), 2 prospective studies (56 patients), and 5 case studies (5 patients). Two articles were sub-analyses of a randomised clinical trial. Methods used in these studies were heterogeneous. Only 6 studies did not find a significant effect of tDCS on language performance. As compared with earlier meta-analyses, the 2 latest found significant effects.
CONCLUSION
Evidence from published peer reviewed literature is effective for post-stroke aphasia rehabilitation at the chronic stages. tDCS devices are easy to use, safe and inexpensive. They can be used in routine clinical practice by speech therapists for aphasia rehabilitation. However, further studies should investigate the effectiveness in the subacute post-stroke phase and determine the effect of the lesion for precisely identifying the targeted brain areas. We discuss crucial challenges for future studies.
背景
经颅直流电刺激（tDCS）是一种非侵入性工具，可在大脑中诱导神经调节。多项研究表明 tDCS 可有效改善中风后失语症的语言恢复。然而，这种创新技术目前并未在常规言语和语言治疗（SLT）实践中使用。
目的
本系统综述旨在总结 tDCS 在失语症康复中的作用。
方法
我们于 2018 年 10 月 5 日通过 PubMed 检索 MEDLINE 和 Scopus 以检索 1996 年至 2018 年发表的英文文章。纳入的研究涉及 tDCS 联合或不联合 SLT 治疗中风后失语症康复。
结果
我们保留了 5 项荟萃分析和 48 项研究。在这 48 项研究中，有 39 项是随机对照试验（558 例患者）、2 项前瞻性研究（56 例患者）和 5 项病例研究（5 例患者）。有 2 篇文章是一项随机临床试验的亚分析。这些研究中使用的方法具有异质性。只有 6 项研究未发现 tDCS 对语言表现有显著影响。与早期的荟萃分析相比，最近的 2 项荟萃分析发现了显著的效果。
结论
来自已发表的同行评议文献的证据对慢性期中风后失语症康复有效。tDCS 设备易于使用、安全且价格低廉。言语治疗师可以在常规临床实践中使用它们进行失语症康复。然而，还需要进一步的研究来调查亚急性期中风后阶段的效果，并确定病变的影响，以准确确定靶向大脑区域。我们讨论了未来研究的关键挑战。
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