Kliniken Schmieder, Allensbach, Germany.
Kliniken Schmieder, Allensbach, Germany.
Clin Neurophysiol. 2022 Dec;144:16-22. doi: 10.1016/j.clinph.2022.09.003. Epub 2022 Sep 17.
To characterize motor excitability changes and changes of motor performance induced by a single anodal and cathodal transcranial direct current stimulation (tDCS) session in stroke patients.
Twenty subacute stroke patients participated. Motor performance was tested with the Box and Block Test [BBT]. Motor cortex excitability (short interval intracortical inhibition [SICI], intracortical facilitation [ICF], long interval intracortical inhibition [LICI]) was examined by paired pulse transcranial magnetic stimulation before and after a single tDCS session (20 minutes, 1,0 mA). On two different occasions, patients received anodal and cathodal tDCS over the affected hemisphere. TMS recordings were taken from both hands consecutively.
Anodal tDCS significantly reduced SICI without changing ICF or LICI. Cathodal tDCS did not change motor excitability. Both types of tDCS did not alter motor performance. Even prior to anodal tDCS, SICI in the affected hemisphere was lower than in the unaffected hemisphere and was correlated with BBT changes after anodal tDCS.
Anodal, but not cathodal tDCS specifically modulated intracortical inhibitory circuits, leading to a disinhibition.
The results amplify our knowledge on excitability modulations of tDCS in stroke patients.
描述单次阳极和阴极经颅直流电刺激（tDCS）对脑卒中患者运动兴奋性和运动表现的影响。
20 名亚急性期脑卒中患者参与了本研究。运动表现通过 Box and Block Test [BBT] 进行测试。在单次 tDCS 治疗（20 分钟，1.0 mA）前后，采用成对脉冲经颅磁刺激技术检测运动皮层兴奋性（短间隔皮质内抑制[SICI]、皮质内易化[ICF]、长间隔皮质内抑制[LICI]）。在两种不同情况下，患者接受了患侧的阳极和阴极 tDCS 刺激。TMS 记录连续取自双手。
阳极 tDCS 显著降低了 SICI，而不改变 ICF 或 LICI。阴极 tDCS 未改变运动兴奋性。两种类型的 tDCS 均未改变运动表现。即使在阳极 tDCS 之前，患侧半球的 SICI 也低于非患侧半球，且与阳极 tDCS 后 BBT 的变化相关。
阳极 tDCS 特异性地调节了皮质内抑制性回路，导致去抑制。
研究结果增加了我们对 tDCS 调节脑卒中患者兴奋性的认识。
