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40赫兹视觉-听觉刺激诱导的γ振荡用于中风后急性期肢体运动康复治疗:一项前瞻性随机对照试验的研究方案

Gamma oscillations induced by 40-Hz visual-auditory stimulation for the treatment of acute-phase limb motor rehabilitation after stroke: study protocol for a prospective randomized controlled trial.

作者信息

Fu Wang, Yu Xiaoming, Lai Minghui, Li Yuanli, Yang Yingting, Qin Yong, Yu Min, Wang Feng, Wang Cong

机构信息

Department of Neurology, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Datong Rd. 358, Shanghai, 200137, China.

Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China.

出版信息

Trials. 2024 Apr 26;25(1):284. doi: 10.1186/s13063-024-08121-w.

Abstract

BACKGROUND

The incidence of hemiparetic limb dysfunction reaches 85% in stroke patients, emerging as a critical factor influencing their daily lives. However, the effectiveness of current rehabilitation treatments is considerably limited, particularly in patients with upper extremity impairment. This study aims to conduct a prospective clinical trial to validate the safety and effectiveness of gamma oscillations induced by 40-Hz visual-auditory stimulation in treating post-stroke upper limb dysfunction and to explore the relevant mechanisms.

METHODS

This trial is a prospective, randomized controlled, double-blind study. All enrolled patients were randomly assigned to two groups. The experimental group received intervention through 40-Hz visual-auditory stimulation, while the control group underwent intervention with randomly matched visual-auditory stimulation frequencies. The primary efficacy endpoint is the change in motor function. Secondary efficacy endpoints include motor-evoked potentials, cerebral hemodynamic changes, neural network connectivity, and alterations in synaptic-related genes. Safety evaluation included major adverse events, all-cause mortality, and photosensitive epilepsy. Assessments will be conducted at baseline, after a 14-day treatment period, and during subsequent follow-up visits (at 3 and 6 months) post-treatment. The differences between the two groups will be compared.

DISCUSSION

This study will evaluate the safety and efficacy of gamma oscillations induced by 40-Hz visual-auditory stimulation in treating patients with upper extremity dysfunction after an acute cerebral stroke. Concurrently, we will explore potential mechanisms, including changes in synaptic-related genes and neural network connectivity. This trial is expected to provide evidence for the effectiveness of this new technique in treating upper extremity dysfunction after a stroke and improving patients' quality of life.

TRIAL REGISTRATION

The study protocol has been registered with the Chinese Clinical Trial Registry (ChiCTR) under registration number ChiCTR2300076579 on October 12, 2023.

摘要

背景

中风患者偏瘫肢体功能障碍的发生率达85%,成为影响其日常生活的关键因素。然而,目前康复治疗的效果相当有限,尤其是在上肢功能受损的患者中。本研究旨在进行一项前瞻性临床试验,以验证40赫兹视觉-听觉刺激诱导的伽马振荡治疗中风后上肢功能障碍的安全性和有效性,并探索相关机制。

方法

本试验为前瞻性、随机对照、双盲研究。所有入组患者随机分为两组。试验组通过40赫兹视觉-听觉刺激进行干预,而对照组接受随机匹配的视觉-听觉刺激频率干预。主要疗效终点是运动功能的变化。次要疗效终点包括运动诱发电位、脑血流动力学变化、神经网络连通性以及突触相关基因的改变。安全性评估包括严重不良事件、全因死亡率和光敏性癫痫。将在基线、14天治疗期后以及治疗后的后续随访(3个月和6个月)时进行评估。比较两组之间的差异。

讨论

本研究将评估40赫兹视觉-听觉刺激诱导的伽马振荡治疗急性脑中风后上肢功能障碍患者的安全性和有效性。同时,我们将探索潜在机制,包括突触相关基因和神经网络连通性的变化。本试验有望为这项新技术治疗中风后上肢功能障碍及改善患者生活质量的有效性提供证据。

试验注册

该研究方案已于2023年10月12日在中国临床试验注册中心(ChiCTR)注册,注册号为ChiCTR2300076579。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f387/11046895/b22b8b1488d4/13063_2024_8121_Fig1_HTML.jpg

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