比较经颅直流电刺激在慢性脑卒中双任务行走和皮质活动中的不同模式：双盲随机对照试验。
Comparing different montages of transcranial direct current stimulation on dual-task walking and cortical activity in chronic stroke: double-blinded randomized controlled trial.
机构信息
Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Division of Nerve Repair- Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
出版信息
BMC Neurol. 2022 Mar 25;22(1):119. doi: 10.1186/s12883-022-02644-y.
BACKGROUND
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation to modulate cortical activity for improving motor function. However, the different tDCS applications for modulating cortical activity and dual task gait performance in chronic stroke have not yet been investigated. This study investigated the effects of different tDCS applications on dual task gait performance and contralesional M1 activation in chronic stroke.
METHODS
Forty-eight participants were randomized to anodal, bilateral, cathodal, and sham tDCS groups. Each group received 20 min of tDCS stimulation, except the sham group. Gait performance was measured by GaitRite system during cognitive dual task (CDT) walking, motor dual task (MDT) walking, and single walking (SW). Contralesional M1 activity of unaffected tibialis anterior (TA) was measured using transcranial magnetic stimulation (TMS). Intragroup difference was analyzed by Wilconxon sign ranks test with Bonferroni correction, and Kruskal-Wallis one-way analysis of variance by ranks was used for intergroup comparisons, followed by post-hoc Mann-Whitney U tests with Bonferroni correction.
RESULTS
The bilateral tDCS (p = 0.017) and cathodal tDCS (p = 0.010) improved the CDT walking speed more than sham group. The bilateral tDCS (p = 0.048) and cathodal tDCS (p = 0.048) also improved the MDT walking speed more than sham group. Furthermore, bilateral tDCS (p = 0.012) and cathodal tDCS (p = 0.040) increased the silent period (SP) more than the anodal and sham group. Thus, one-session of bilateral and cathodal tDCS improved dual task walking performance paralleled with increasing contralesional corticomotor inhibition in chronic stroke.
CONCLUSIONS
Our results indicate that one-session of bilateral and cathodal tDCS increased contralesional corticomotor inhibition and improved dual task gait performance in chronic stroke.
TRIAL REGISTRATION
Thai Clinical Trials Registry (TCTR20180116001). Registered prospectively on 16th Jan, 2018 at http://www.thaiclinicaltrials.org .
背景
经颅直流电刺激（tDCS）是一种非侵入性的大脑刺激方法，可调节皮质活动，改善运动功能。然而，不同的 tDCS 应用程序用于调节皮质活动和慢性中风的双重任务步态表现尚未得到研究。本研究调查了不同 tDCS 应用程序对慢性中风双重任务步态表现和对侧 M1 激活的影响。
方法
48 名参与者随机分为阳极、双侧、阴极和假 tDCS 组。除假组外，每组均接受 20 分钟的 tDCS 刺激。步态表现通过步态分析系统在认知双重任务（CDT）行走、运动双重任务（MDT）行走和单步行走（SW）期间进行测量。使用经颅磁刺激（TMS）测量非受累胫骨前肌（TA）的对侧 M1 活动。采用 Wilcoxon 符号秩检验和 Bonferroni 校正进行组内差异分析，采用 Kruskal-Wallis 单向方差分析进行组间比较，然后采用 Bonferroni 校正的事后 Mann-Whitney U 检验。
结果
双侧 tDCS（p=0.017）和阴极 tDCS（p=0.010）比假组更能提高 CDT 行走速度。双侧 tDCS（p=0.048）和阴极 tDCS（p=0.048）也比假组更能提高 MDT 行走速度。此外，双侧 tDCS（p=0.012）和阴极 tDCS（p=0.040）比阳极和假组增加了静息期（SP）。因此，单次双侧和阴极 tDCS 改善了双重任务行走表现，同时增加了慢性中风的对侧皮质运动抑制。
结论
我们的结果表明，单次双侧和阴极 tDCS 增加了对侧皮质运动抑制，并改善了慢性中风的双重任务步态表现。
试验注册
泰国临床试验注册中心（TCTR20180116001）。于 2018 年 1 月 16 日在 http://www.thaiclinicaltrials.org 前瞻性注册。
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