Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, CIC 805, Physiology-Functional Testing Ward, Raymond-Poincaré Teaching Hospital, University of Versailles Saint-Quentin-en-Yvelines, AP-HP, 92380 Garches, France; Nantes Université, Movement - Interactions - Performance, MIP, EA 4334, 44000 Nantes, France.
Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, CIC 805, Physiology-Functional Testing Ward, Raymond-Poincaré Teaching Hospital, University of Versailles Saint-Quentin-en-Yvelines, AP-HP, 92380 Garches, France.
Neurophysiol Clin. 2019 Sep;49(4):283-293. doi: 10.1016/j.neucli.2019.07.012. Epub 2019 Jul 30.
The excitability of some neural circuits involved in walking and affected in individuals with chronic stroke can be modulated during and/or immediately after anodal transcranial direct current stimulation (a-tDCS). This study was designed to investigate the effects of a-tDCS during and immediately after application on leg muscle activity during gait, and on spatiotemporal and kinematic gait parameters in patients with chronic stroke.
This study was randomized, sham-controlled and double-blinded with a cross-over design and included 24 individuals with chronic stroke. Each participant underwent one 30-minute session each of effective a-tDCS at 2mA and sham tDCS. In both sessions, the anode was placed over the leg motor cortex of the affected hemisphere and the cathode over the contralateral orbit. Six gait trials were performed before, during and immediately after each effective/sham tDCS session. Electromyographic activity of leg muscles, as well as spatiotemporal (e.g. gait speed) and kinematic (e.g. peak knee flexion and ankle dorsiflexion in the swing phase of gait) gait parameters were recorded. Genotyping for the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism was undertaken since this gene may influence motor skill learning and the effects of tDCS.
No significant effects of a-tDCS on gait parameters were found either for the total group or for the Val66Met (N=10) and Val66Val (N=14) subgroups.
A single session of a-tDCS delivered to the leg motor cortex did not immediately improve gait parameters in individuals with chronic stroke, regardless of their BDNF genotype.
一些与行走有关并受慢性中风影响的神经回路的兴奋性可以在阳极经颅直流电刺激(a-tDCS)期间和/或之后被调节。本研究旨在调查 a-tDCS 在应用期间和之后立即对慢性中风患者行走时腿部肌肉活动以及时空和运动学步态参数的影响。
本研究采用随机、假对照和双盲交叉设计,包括 24 名慢性中风患者。每位参与者接受一次有效的 2mA a-tDCS 和假 tDCS 各 30 分钟的治疗。在两次治疗中,阳极置于患侧半球的腿部运动皮层上,阴极置于对侧眼眶上。在每次有效/假 tDCS 治疗前后进行 6 次步态试验。记录腿部肌肉的肌电图活动以及时空(例如,步行速度)和运动学(例如,步行摆动相时的膝关节最大屈曲和踝关节背屈)步态参数。由于该基因可能影响运动技能学习和 tDCS 的效果,因此对脑源性神经营养因子(BDNF)Val66Met 多态性进行了基因分型。
无论是在总组还是在 Val66Met(N=10)和 Val66Val(N=14)亚组中,a-tDCS 对步态参数均无显著影响。
单次腿部运动皮层的 a-tDCS 治疗并不能立即改善慢性中风患者的步态参数,无论其 BDNF 基因型如何。