Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy.
Department of Psychology, NeuroMi, University of Milano Bicocca, Milan, Italy.
Neural Plast. 2019 Jan 15;2019:2184398. doi: 10.1155/2019/2184398.
Transcranial Direct Current Stimulation (tDCS) is an emerging tool to improve upper limb motor functions after stroke acquired in adulthood; however, there is a paucity of reports on its efficacy for upper limb motor rehabilitation in congenital or early-acquired stroke. In this pilot study we have explored, for the first time, the immediate effects, and their short-term persistence, of a single application of anodal tDCS on chronic upper limb motor disorders in children and young individuals with Unilateral Cerebral Palsy (UCP). To this aim, in a crossover sham-controlled study, eight subjects aged 10-28 years with UCP underwent two sessions of and tDCS. Anodal tDCS (1.5 mA, 20 min) was delivered over the primary motor cortex (M1) of the ipsilesional hemisphere. Results showed, only following the active stimulation, an immediate improvement in unimanual gross motor dexterity of hemiplegic, but not of nonhemiplegic, hand in Box and Block test (BBT). Such improvement remained stable for at least 90 minutes. Performance of both hands in Hand Grip Strength test was not modified by anodal tDCS. Improvement in BBT was unrelated to participants' age or lesion size, as revealed by MRI data analysis. No serious adverse effects occurred after tDCS; some mild and transient side effects (e.g., headache, tingling, and itchiness) were reported in a limited number of cases. This study provides an innovative contribution to scientific literature on the efficacy and safety of anodal tDCS in UCP. This trial is registered with NCT03137940.
经颅直流电刺激（tDCS）是一种新兴的工具，可改善成人获得性中风后的上肢运动功能；然而，关于其在先天性或早期获得性中风上肢运动康复中的疗效的报告很少。在这项初步研究中，我们首次探索了单次阳极 tDCS 对单侧脑瘫（UCP）儿童和年轻患者慢性上肢运动障碍的即时影响及其短期持续时间。为此，在交叉假对照研究中，8 名年龄在 10-28 岁的 UCP 患者接受了 和 tDCS 的两次治疗。阳极 tDCS（1.5 mA，20 分钟）施加于对侧大脑半球的初级运动皮层（M1）。结果表明，仅在主动刺激后，偏瘫手的单手总体运动灵巧性立即改善，但非偏瘫手的运动灵巧性没有改善，在箱式和块状测试（BBT）中。这种改善至少稳定 90 分钟。双手在握力测试中的表现并未因阳极 tDCS 而改变。BBT 的改善与参与者的年龄或 MRI 数据分析所示的病变大小无关。tDCS 后未发生严重不良事件；少数情况下报告了一些轻度和短暂的副作用（例如，头痛，刺痛和瘙痒）。这项研究为阳极 tDCS 在 UCP 中的疗效和安全性的科学文献提供了创新性贡献。这项试验在 NCT03137940 注册。
