Leonardi Giulia, Ciurleo Rosella, Cucinotta Francesca, Fonti Bartolo, Borzelli Daniele, Costa Lara, Tisano Adriana, Portaro Simona, Alito Angelo
Department of Physical and Rehabilitation Medicine and Sports Medicine, Policlinico "G. Martino," Messina, Italy.
IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy.
Front Syst Neurosci. 2022 Jul 29;16:947421. doi: 10.3389/fnsys.2022.947421. eCollection 2022.
Stroke is the second cause of disability and death worldwide, highly impacting patient's quality of life. Several changes in brain architecture and function led by stroke can be disclosed by neurophysiological techniques. Specifically, electroencephalogram (EEG) can disclose brain oscillatory rhythms, which can be considered as a possible outcome measure for stroke recovery, and potentially shaped by neuromodulation techniques. We performed a review of randomized controlled trials on the role of brain oscillations in patients with post-stroke searching the following databases: Pubmed, Scopus, and the Web of Science, from 2012 to 2022. Thirteen studies involving 346 patients in total were included. Patients in the control groups received various treatments (sham or different stimulation modalities) in different post-stroke phases. This review describes the state of the art in the existing randomized controlled trials evaluating post-stroke motor function recovery after conventional rehabilitation treatment associated with neuromodulation techniques. Moreover, the role of brain pattern rhythms to modulate cortical excitability has been analyzed. To date, neuromodulation approaches could be considered a valid tool to improve stroke rehabilitation outcomes, despite more high-quality, and homogeneous randomized clinical trials are needed to determine to which extent motor functional impairment after stroke can be improved by neuromodulation approaches and which one could provide better functional outcomes. However, the high reproducibility of brain oscillatory rhythms could be considered a promising predictive outcome measure applicable to evaluate patients with stroke recovery after rehabilitation.
中风是全球致残和致死的第二大原因，对患者的生活质量有重大影响。中风导致的大脑结构和功能的多种变化可通过神经生理学技术揭示。具体而言，脑电图（EEG）可以揭示大脑振荡节律，这可被视为中风恢复的一种可能的结果指标，并且可能受到神经调节技术的影响。我们检索了2012年至2022年的Pubmed、Scopus和Web of Science等数据库，对关于脑振荡在中风后患者中的作用的随机对照试验进行了综述。总共纳入了13项研究，涉及346名患者。对照组患者在中风后的不同阶段接受了各种治疗（假治疗或不同的刺激方式）。本综述描述了现有随机对照试验的现状，这些试验评估了与神经调节技术相关的传统康复治疗后中风后运动功能的恢复情况。此外，还分析了脑电模式节律对调节皮层兴奋性的作用。迄今为止，神经调节方法可被视为改善中风康复结果的有效工具，尽管还需要更多高质量、同质化的随机临床试验来确定神经调节方法能在多大程度上改善中风后的运动功能障碍以及哪种方法能提供更好的功能结果。然而，脑振荡节律的高可重复性可被视为一种有前景的预测性结果指标，适用于评估中风康复后的患者。
