Feil Sarah, Eisenhut Peter, Strakeljahn Frauke, Müller Sarah, Nauer Claude, Bansi Jens, Weber Stefan, Liebs Alexandra, Lefaucheur Jean-Pascal, Kesselring Jürg, Gonzenbach Roman, Mylius Veit
Department of Neurology, Center for Neurorehabilitation, Valens, Switzerland.
Schweizer Hochschule für Logopädie Rorschach, Rorschach, Switzerland.
Front Neurosci. 2019 Apr 26;13:295. doi: 10.3389/fnins.2019.00295. eCollection 2019.
Both anodal transcranial direct current stimulation (tDCS) of the left IFG and cathodal stimulation of the right IFG were shown to improve rehabilitation of stroke patients with Broca's aphasia. The study aimed at assessing the impact of a bihemispheric IFG stimulation compared to sham on postacute non-fluent aphasia. Twelve patients with non-fluent aphasia were included at least 4 weeks following cerebral stroke. Ten daily sessions of 2 mA bihemispheric verum or sham tDCS (anode on left IFG and cathode on right IFG) were performed concomitantly with individual language therapy in a double-blinded randomized controlled study with parallel group design. Language functions [i.e., communication (ANELT), picture naming and the Aachen aphasia test (AAT)] were assessed up to 1 month following tDCS. The picture naming task significantly improved (increased number of nouns) at the end of the tDCS procedure in the verum but not sham group. Improvements in the picture naming task and the communication task of the AAT at 4 weeks after tDCS procedure were only seen in the verum group. In patients with postacute cerebral stroke, repeated sessions of tDCS applied on both IFG concomitantly with language therapy were able to induce immediate effects on picture naming presumably due to an early left shift of language-associated function that maintained for 4 weeks. Effects on clinically relevant communicative abilities are likely.
研究表明,对左侧额下回进行阳极经颅直流电刺激(tDCS)以及对右侧额下回进行阴极刺激,均能改善布罗卡失语症中风患者的康复情况。本研究旨在评估与假刺激相比,双侧额下回刺激对急性后期非流畅性失语症的影响。纳入12例非流畅性失语症患者,均为脑卒中后至少4周的患者。在一项采用平行组设计的双盲随机对照研究中,每天进行10次2 mA的双侧真性或假性tDCS(阳极置于左侧额下回,阴极置于右侧额下回),同时进行个体化语言治疗。在tDCS后长达1个月的时间内评估语言功能[即交流(ANELT)、图片命名和亚琛失语症测试(AAT)]。在tDCS疗程结束时,真性刺激组的图片命名任务有显著改善(名词数量增加),而假刺激组则无改善。仅在真性刺激组中观察到tDCS疗程后4周时AAT的图片命名任务和交流任务有所改善。对于急性后期脑卒中患者,在进行语言治疗的同时对双侧额下回重复进行tDCS治疗,可能会对图片命名产生即时效应,这可能是由于与语言相关的功能早期向左半球转移并持续了4周。对临床相关的交流能力可能也有影响。