School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei.
Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan.
Neurorehabil Neural Repair. 2022 Sep;36(9):645-654. doi: 10.1177/15459683221121751. Epub 2022 Sep 1.
High-definition transcranial electrical theta burst superimposing direct current stimulation (HD-tDCS-eTBS) not only incorporates the therapeutic advantages of tDCS and TBS but enhances stimulation focality and practicality. However, the applicability of this innovative neuromodulatory device in post-stroke rehabilitation remains uncertain.
This study aimed to assess the efficacy and safety of the HD-tDCS-eTBS on upper extremity (UE) motor function in patients with chronic stroke.
A patient-blinded, randomized controlled study was conducted. Twenty-four participants were randomly assigned into either the active HD-tDCS-eTBS group or sham HD-tDCS-eTBS group. Both groups received 20 minutes of active/sham HD-tDCS-eTBS combined with 30 minutes of conventional UE rehabilitation each time, 3 times a week for 4 weeks. Outcome measures including the Fugl-Meyer Assessment of Upper Extremity, Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, Finger-Nose Test, and Modified Ashworth Scale were assessed before and immediately after the intervention period.
Spasticity of shoulder adductor ( = .05), elbow extensor ( = .04), and thumb flexor ( < .01) were significantly reduced in the active HD-tDCS-eTBS group versus the sham group. Nonsignificant trends in the improvements of most other outcome measures were in favor of the active HD-tDCS-eTBS group with moderate to large effect sizes ( = .06-.26, = 0.06-0.16). No severe adverse events except for slight skin redness under the stimulus electrode was detected after the HD-tDCS-eTBS.
Our findings support that HD-tDCS-eTBS is safe and has therapeutic potential for post-stroke UE motor rehabilitation.
ClinicalTrials.gov (ID: NCT04278105).
高清晰度经颅电θ爆发叠加直流电刺激（HD-tDCS-eTBS）不仅融合了 tDCS 和 TBS 的治疗优势，还增强了刺激的聚焦性和实用性。然而，这种创新的神经调节设备在脑卒中后康复中的适用性尚不确定。
本研究旨在评估 HD-tDCS-eTBS 对慢性脑卒中患者上肢（UE）运动功能的疗效和安全性。
进行了一项患者盲、随机对照研究。24 名参与者被随机分配到主动 HD-tDCS-eTBS 组或假 HD-tDCS-eTBS 组。两组均接受 20 分钟主动/假 HD-tDCS-eTBS 治疗，同时结合 30 分钟常规 UE 康复治疗，每周 3 次，共 4 周。在干预前后分别评估 Fugl-Meyer 上肢评估、Wolf 运动功能测试、Jebsen-Taylor 手功能测试、指鼻测试和改良 Ashworth 量表等结果测量指标。
与假刺激组相比，主动 HD-tDCS-eTBS 组的肩部内收肌（ = .05）、肘部伸肌（ = .04）和拇指屈肌（ < .01）的痉挛明显减轻。大多数其他结果测量指标的改善趋势也有利于主动 HD-tDCS-eTBS 组，但效果大小为中等至较大（ = .06-.26， = 0.06-0.16）。除刺激电极下皮肤轻微发红外，未发现 HD-tDCS-eTBS 后严重不良事件。
我们的研究结果支持 HD-tDCS-eTBS 是安全的，并且对脑卒中后 UE 运动康复具有治疗潜力。
ClinicalTrials.gov（ID：NCT04278105）。
