He Wenjie, Huang Yuan, He Lu, Liu Liru, Zeng Peishan, Qiu Huiying, Wang Xiaoyue, Zhou Hongyu, Chen Zhaofang, Xu Yi, Zhao Jingyi, Wang Wenda, Tang Hongmei, Xu Kaishou
Department of Rehabilitation, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
School of Medicine, South China University of Technology, Guangzhou, China.
Front Behav Neurosci. 2022 Sep 9;16:925122. doi: 10.3389/fnbeh.2022.925122. eCollection 2022.
Transcranial direct current stimulation (tDCS) has shown a promising prospect in improving function and spasticity in school-aged children with cerebral palsy, but little is known in preschool children. The aim of this study was to explore the safety and effects of tDCS on hand function in preschool children (aged 3-6 years) with hemiplegic cerebral palsy (HCP). We designed a crossover, single-blind, sham-controlled study in 30 preschool children with HCP, who were recruited to receive one session of sham and one session of active anodal tDCS (1.5 mA, 20 min) on the primary motor cortex of the affected hemisphere, with a 24-h interval between the two sessions. Questionnaire was completed by each participant and their attendants immediately, 90 min, and 24 h after each session to monitor common adverse events of tDCS, such as skin irritation, skin erythema, burning sensation, headache, dizziness, etc. Box and Block Test, Selective Control of the Upper Extremity Scale, Modified Ashworth Scale, and Melbourne Assessment 2 were conducted at baseline, immediately, and 90 min after each session. No severe adverse event occurred during the study and only a few of them felt transient and slight discomfort. Results also showed that all participants performed better at Box and Block Test of the hemiplegic hand immediately after a single anodal tDCS ( < 0.05) and this improvement lasted at least 90 min and more than 24 h. However, there was no significant improvement in Selective Control of the Upper Extremity Scale of both hands, Box and Block Test of the non-hemiplegic hand, Modified Ashworth Scale, and Melbourne Assessment 2 of the hemiplegic upper limb ( > 0.05). Shortly, this study supported the safety and effects of a single anodal tDCS on improving the manual dexterity of the hemiplegic hand for preschool children with HCP. Further researches with larger samples about the optimal dose and treatment cycle of tDCS for preschool children with HCP are warranted. This study gained the approval of ethics committee of the organization and was registered at chictr.org (ChiCTR2000031141).
经颅直流电刺激（tDCS）在改善学龄期脑瘫儿童的功能和痉挛方面已显示出有前景的效果，但对于学龄前儿童的情况却知之甚少。本研究的目的是探讨tDCS对偏瘫型脑瘫（HCP）学龄前儿童（3至6岁）手部功能的安全性和效果。我们对30名HCP学龄前儿童设计了一项交叉、单盲、假刺激对照研究，招募他们在患侧半球的初级运动皮层接受一次假刺激和一次主动阳极tDCS（1.5毫安，20分钟），两次刺激之间间隔24小时。每次刺激后，由每位参与者及其陪同人员立即、90分钟和24小时填写问卷，以监测tDCS的常见不良事件，如皮肤刺激、皮肤红斑、烧灼感、头痛、头晕等。在基线、每次刺激后立即和90分钟时进行箱块测试、上肢选择性控制量表、改良Ashworth量表和墨尔本评估2。研究期间未发生严重不良事件，只有少数人感到短暂轻微不适。结果还显示，单次阳极tDCS后，所有参与者偏瘫手的箱块测试成绩立即有所提高（<0.05），且这种改善至少持续90分钟及超过24小时。然而，双手的上肢选择性控制量表、非偏瘫手的箱块测试、改良Ashworth量表以及偏瘫上肢的墨尔本评估2均无显著改善（>0.05）。简而言之，本研究支持单次阳极tDCS对改善HCP学龄前儿童偏瘫手的手部灵活性的安全性和效果。有必要对HCP学龄前儿童tDCS的最佳剂量和治疗周期进行更大样本的进一步研究。本研究获得了该机构伦理委员会的批准，并在chictr.org（ChiCTR2000031141）注册。
