Taud Benedikt, Lindenberg Robert, Darkow Robert, Wevers Jasmin, Höfflin Dorothee, Grittner Ulrike, Meinzer Marcus, Flöel Agnes
Neurocure Cluster of Excellence, Charité University Medicine, Berlin, Germany.
Department of History, Philosophy and Ethics of Medicine, Heinrich Heine University, Düsseldorf, Germany.
Front Neurol. 2021 Nov 11;12:736075. doi: 10.3389/fneur.2021.736075. eCollection 2021.
This randomized controlled trial investigated if uni- and bihemispheric transcranial direct current stimulation (tDCS) of the motor cortex can enhance the effects of visuo-motor grip force tracking task training and transfer to clinical assessments of upper extremity motor function. In a randomized, double-blind, sham-controlled trial, 40 chronic stroke patients underwent 5 days of visuo-motor grip force tracking task training of the paretic hand with either unilateral or bilateral ( = 15/group) or placebo tDCS ( = 10). Immediate and long-term (3 months) effects on training outcome and motor recovery (Upper Extremity Fugl-Meyer, UE-FM, Wolf Motor Function Test, and WMFT) were investigated. Trained task performance significantly improved independently of tDCS in a curvilinear fashion. In the anodal stimulation group UE-FM scores were higher than in the sham group at day 5 (adjusted mean difference: 2.6, 95%CI: 0.6-4.5, = 0.010) and at 3 months follow up (adjusted mean difference: 2.8, 95%CI: 0.8-4.7, = 0.006). Neither training alone, nor the combination of training and tDCS improved WMFT performance. Visuo-motor grip force tracking task training can facilitate recovery of upper extremity function. Only minimal add-on effects of anodal but not dual tDCS were observed. https://clinicaltrials.gov/ct2/results?recrs=&cond=&term=NCT01969097&cntry=&state=&city=&dist=, identifier: NCT01969097, retrospectively registered on 25/10/2013.
这项随机对照试验研究了运动皮层的单半球和双半球经颅直流电刺激（tDCS）是否能增强视觉运动握力跟踪任务训练的效果，并转化为上肢运动功能的临床评估。在一项随机、双盲、假刺激对照试验中，40名慢性中风患者对患侧手进行了5天的视觉运动握力跟踪任务训练，训练过程中接受单侧或双侧tDCS（每组15人）或安慰剂tDCS（10人）。研究了对训练结果和运动恢复（上肢Fugl-Meyer评估量表、UE-FM、Wolf运动功能测试和WMFT）的即时和长期（3个月）影响。训练任务表现以曲线方式显著改善，且与tDCS无关。在阳极刺激组中，第5天（调整后平均差异：2.6，95%CI：0.6 - 4.5，P = 0.010）和3个月随访时（调整后平均差异：2.8，95%CI：0.8 - 4.7，P = 0.006）的UE-FM评分高于假刺激组。单独训练以及训练与tDCS联合均未改善WMFT表现。视觉运动握力跟踪任务训练可促进上肢功能恢复。仅观察到阳极tDCS有最小的附加效应，而双tDCS没有。https://clinicaltrials.gov/ct2/results?recrs=&cond=&term=NCT0*******, 标识符：NCT01969097，于2013年10月25日进行回顾性注册。
