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经颅直流电刺激双侧辅助运动区对一名严重运动麻痹中风患者下肢运动功能的影响:一项病例研究

Effects of Transcranial Direct Current Stimulation of Bilateral Supplementary Motor Area on the Lower Limb Motor Function in a Stroke Patient with Severe Motor Paralysis: A Case Study.

作者信息

Ohnishi Sora, Mizuta Naomichi, Hasui Naruhito, Taguchi Junji, Nakatani Tomoki, Morioka Shu

机构信息

Department of Therapy, Takarazuka Rehabilitation Hospital, Medical Corporation SHOWAKAI, 22-2 Tsurunoso, Takarazuka 665-0833, Japan.

Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, 4-2-2 Umaminaka, Koryo, Kitakatsuragi-gun, Nara 635-0832, Japan.

出版信息

Brain Sci. 2022 Mar 28;12(4):452. doi: 10.3390/brainsci12040452.

Abstract

In patients with severe motor paralysis, increasing the excitability of the supplementary motor area (SMA) in the non-injured hemisphere contributes to the recovery of lower limb motor function. However, the contribution of transcranial direct current stimulation (tDCS) over the SMA of the non-injured hemisphere in the recovery of lower limb motor function is unclear. This study aimed to examine the effects of tDCS on bilateral hemispheric SMA combined with assisted gait training. A post-stroke patient with severe motor paralysis participated in a retrospective AB design. Assisted gait training was performed only in period A and tDCS to the SMA of the bilateral hemisphere combined with assisted gait training (bi-tDCS) was performed in period B. Additionally, three conditions were performed for 20 min each in the intervals between the two periods: (1) assisted gait training only, (2) assisted gait training combined with tDCS to the SMA of the injured hemisphere, and (3) bi-tDCS. Measurements were muscle activity and beta-band intermuscular coherence (reflecting corticospinal tract excitability) of the vastus medialis muscle. The bi-tDCS immediately and longitudinally increased muscle activity and intermuscular coherence. We consider that bi-tDCS may be effective in recovering lower limb motor function in a patient with severe motor paralysis.

摘要

在严重运动麻痹患者中,提高未受损半球辅助运动区(SMA)的兴奋性有助于下肢运动功能的恢复。然而,经颅直流电刺激(tDCS)作用于未受损半球的SMA对下肢运动功能恢复的作用尚不清楚。本研究旨在探讨tDCS联合辅助步态训练对双侧半球SMA的影响。一名患有严重运动麻痹的中风后患者参与了一项回顾性AB设计。仅在A期进行辅助步态训练,在B期进行tDCS刺激双侧半球的SMA联合辅助步态训练(双侧tDCS)。此外,在两个阶段的间隔期间分别进行三种条件,每种条件持续20分钟:(1)仅辅助步态训练,(2)辅助步态训练联合tDCS刺激受损半球的SMA,(3)双侧tDCS。测量指标为股内侧肌的肌肉活动和β波段肌间相干性(反映皮质脊髓束兴奋性)。双侧tDCS即刻和长期增加了肌肉活动和肌间相干性。我们认为双侧tDCS可能对严重运动麻痹患者恢复下肢运动功能有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc09/9029581/2d654a26d007/brainsci-12-00452-g001.jpg

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