Xing Xiang-Xin, Wu Jia-Jia, Qu Jiao, Ma Jie, Xu Rong, Zhu Yu, Zheng Mou-Xiong, Hua Xu-Yun, Xu Jian-Guang
Rehabilitation Center, Qilu Hospital of Shandong University, Qilu Hospital of Shandong University, Jinan 250012, China.
Department of Rehabilitation Medicine, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
Brain Commun. 2024 Dec 4;6(6):fcae437. doi: 10.1093/braincomms/fcae437. eCollection 2024.
The cortico-cortical paired associative stimulation, a combined stimulation based on two brain regions, may be an effective strategy for stroke rehabilitation. Our aim was to confirm that the cortico-cortical paired associative stimulation strengthens the connection between brain regions in the motor circuit and promotes improvements in motor function. This was a randomized double-blind, controlled Phase II trial. 44 Stroke patients were treated in a rehabilitation hospital from October 2020 to January 2021 and were randomly assigned to the sham stimulation group and the cortico-cortical paired associative stimulation group. Patients in both groups received 12 days of rehabilitation therapy. Cortico-cortical paired associative stimulation group received one treatment of cortico-cortical paired associative stimulation invention. Both groups received behavioural assessments such as the Fugl-Meyer upper-extremity scale and resting-state functional MRI scans prior to the intervention and on Day 14. 40 patients completed the intervention session. The results of Fugl-Meyer upper-extremity scale showed a more significant improvement in motor function in the cortico-cortical paired associative stimulation group (6.33 ± 1.29) than in the sham stimulation group (3.16 ± 1.38) ( < 0.001). The functional connectivity showed that cortico-cortical paired associative stimulation strengthens connections between brain regions. Correlation analysis confirmed that the enhancement of functional connectivity was positively correlated with the recovery of Fugl-Meyer upper-extremity scale (r = 0.146, = 0.034; r = 0.211, = 0.0093). The results of functional connectivity suggest that cortico-cortical paired associative stimulation strengthens connections between brain regions. It is expected that this study will provide a positive viewpoint for the neurorehabilitation of stroke patients based on the circuit-level plasticity. (Chinese Clinical Trial Registry: ChiCTR2000036685).
皮质-皮质配对联想刺激是一种基于两个脑区的联合刺激，可能是中风康复的有效策略。我们的目的是证实皮质-皮质配对联想刺激可加强运动回路中脑区之间的连接，并促进运动功能改善。这是一项随机双盲对照II期试验。2020年10月至2021年1月，44名中风患者在一家康复医院接受治疗，并被随机分配到假刺激组和皮质-皮质配对联想刺激组。两组患者均接受了12天的康复治疗。皮质-皮质配对联想刺激组接受了一次皮质-皮质配对联想刺激治疗。两组在干预前和第14天均接受了行为评估，如Fugl-Meyer上肢量表评估和静息态功能磁共振成像扫描。40名患者完成了干预疗程。Fugl-Meyer上肢量表结果显示，皮质-皮质配对联想刺激组（6.33±1.29）的运动功能改善比假刺激组（3.16±1.38）更显著（<0.001）。功能连接性显示，皮质-皮质配对联想刺激可加强脑区之间的连接。相关性分析证实，功能连接性的增强与Fugl-Meyer上肢量表的恢复呈正相关（r=0.146，P=0.034；r=0.211，P=0.0093）。功能连接性结果表明，皮质-皮质配对联想刺激可加强脑区之间的连接。预计本研究将基于回路水平可塑性为中风患者的神经康复提供积极观点。（中国临床试验注册中心：ChiCTR2000036685）
