Shiba Takahiro, Mizuta Naomichi, Hasui Naruhito, Kominami Yohei, Nakatani Tomoki, Taguchi Junji, Morioka Shu
Department of Therapy, Takarazuka Rehabilitation Hospital, Medical Corporation SHOWAKAI, Hyogo, Japan.
Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, Aichi, Japan.
Front Rehabil Sci. 2023 Sep 5;4:1250579. doi: 10.3389/fresc.2023.1250579. eCollection 2023.
Activation of the unaffected hemisphere contributes to motor function recovery post stroke in patients with severe upper limb motor paralysis. Transcranial direct current stimulation (tDCS) has been used in stroke rehabilitation to increase the excitability of motor-related areas. tDCS has been reported to improve upper limb motor function; nonetheless, its effects on corticospinal tract excitability and muscle activity patterns during upper limb exercise remain unclear. Additionally, it is unclear whether simultaneously applied bihemispheric tDCS is more effective than anodal tDCS, which stimulates only one hemisphere. This study examined the effects of bihemispheric tDCS training on corticospinal tract excitability and muscle activity patterns during upper limb movements in a patient with subacute stroke.
In this single-case retrospective study, the Fugl-Meyer Assessment, Box and Block Test, electromyography, and intermuscular coherence measurement were performed. Intermuscular coherence was calculated at 15-30 Hz, which reflects corticospinal tract excitability.
The results indicated that bihemispheric tDCS improved the Fugl-Meyer Assessment, Box and Block Test, co-contraction, and intermuscular coherence results, as compared with anodal tDCS. Discussion: These results reveal that upper limb training with bihemispheric tDCS improves corticospinal tract excitability and muscle activity patterns in patients with subacute stroke.
对于患有严重上肢运动麻痹的中风患者，未受影响半球的激活有助于中风后运动功能的恢复。经颅直流电刺激（tDCS）已被用于中风康复，以提高运动相关区域的兴奋性。据报道，tDCS可改善上肢运动功能；然而，其对上肢运动期间皮质脊髓束兴奋性和肌肉活动模式的影响仍不清楚。此外，尚不清楚同时应用双侧半球tDCS是否比仅刺激一个半球的阳极tDCS更有效。本研究探讨了双侧半球tDCS训练对亚急性中风患者上肢运动期间皮质脊髓束兴奋性和肌肉活动模式的影响。
在这项单病例回顾性研究中，进行了Fugl-Meyer评估、箱块测试、肌电图和肌间相干性测量。肌间相干性在15 - 30Hz计算，反映皮质脊髓束兴奋性。
结果表明，与阳极tDCS相比，双侧半球tDCS改善了Fugl-Meyer评估、箱块测试、共同收缩和肌间相干性结果。讨论：这些结果表明，双侧半球tDCS进行上肢训练可改善亚急性中风患者的皮质脊髓束兴奋性和肌肉活动模式。
