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经颅直流电刺激(tDCS)与跑步机训练对中风所致偏瘫患者自主神经调节的影响——临床测试,对照,随机,双盲

Effects of Transcranial Direct Current Stimulation (tDCS) and Exercises Treadmill on Autonomic Modulation of Hemiparetic Patients Due To Stroke-Clinic Test, Controlled, Randomized, Double-Blind.

作者信息

Heinz Glauber, De Angelis Katia, Dal Corso Simone, Sousa Maria Helena Gomes De, Viana Ariane, Dos Santos Fernando, Corrêa João Carlos Ferrari, Corrêa Fernanda Ishida

机构信息

Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil.

Doctorate and Master Program in Medicine School of University Nove de Julho, UNINOVE, São Paulo, Brazil.

出版信息

Front Neurol. 2020 Jan 22;10:1402. doi: 10.3389/fneur.2019.01402. eCollection 2019.

Abstract

After a Stroke, there is an autonomic nervous system (ANS) changes. Transcranial Direct Current Stimulation (tDCS) can promote the reorganization of the affected circuits. To evaluate the effects of tDCS applied before a session of physical activity on the treadmill, in the modulation of the autonomic nervous system of post-stroke patients. Cross-over study, were randomized 12 adult hemiparetic subjects in 2 groups, Group 1 (active tDCS before exercise on the treadmill) and Group 2 (sham tDCS before exercise on the treadmill). Stimulation times were 20 min; treadmill time was 20 min. The heart rate variability (HRV) and Variability of Systolic Blood Pressure (VSBP) were evaluated for 15 min, in 3 periods (pre and post tDCS and during exercise recovery on the treadmill). There was no difference in the VSBP and the HRV between the groups, compared with the baseline data; however, in the intragroup analysis, the parasympathetic modulation after active tDCS increased by 18% over baseline by the RMSSD with IC 95% (-7.85 to -0.34). In group 1, the post-tDCS active and post-exercise periods presented a value of variance above baseline, indicating a better prognosis. In group 2, there was a significant reduction of 38% of Variance values ( = 0.003) after tDCS sham. tDCS does not generate immediate effects on HRV and VSBP, except for intragroup comparison, which has greater participation in parasympathetic modulation in the group receiving active tDCS.

摘要

中风后,自主神经系统(ANS)会发生变化。经颅直流电刺激(tDCS)可促进受影响神经回路的重组。为评估在跑步机上进行体育活动前应用tDCS对中风后患者自主神经系统调节的影响。采用交叉研究,将12名成年偏瘫受试者随机分为2组,第1组(在跑步机上运动前进行主动tDCS)和第2组(在跑步机上运动前进行假tDCS)。刺激时间为20分钟;跑步机运动时间为20分钟。在3个时间段(tDCS前后以及跑步机运动恢复期间)评估15分钟的心率变异性(HRV)和收缩压变异性(VSBP)。与基线数据相比,两组之间的VSBP和HRV没有差异;然而,在组内分析中,主动tDCS后副交感神经调节通过RMSSD比基线增加了18%,95%置信区间为(-7.85至-0.34)。在第1组中,tDCS后活动期和运动后时期的方差值高于基线,表明预后较好。在第2组中,假tDCS后方差值显著降低了38%(P = 0.003)。除了组内比较外,tDCS对HRV和VSBP没有立即产生影响,在接受主动tDCS的组中,组内比较在副交感神经调节中参与度更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34c5/6988776/ead63e3a286b/fneur-10-01402-g0001.jpg

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