Xia Chun-Ya, Tian Hui-Fang, Ren Xu-Yan, Xiao Zhi-Hang, Chen Hui-An, Yin Yi-Jia, Zhang Le-Chi, Cai Si-Yan, Li Ting-Ting, Zou Jun, Bao Jie, Su Min
Department of Rehabilitation Medicine, The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital), Suzhou, Jiangsu, China.
Institute of Rehabilitation, Soochow University, Suzhou, Jiangsu, China.
Neural Plast. 2025 Aug 6;2025:2886215. doi: 10.1155/np/2886215. eCollection 2025.
Transcranial direct current stimulation (tDCS) and transcutaneous electrical nerve stimulation (TENS) are both recognized for their analgesic effects; however, evidence suggests limitations in their efficacy when applied to knee osteoarthritis (KOA) after stroke. This study aimed to assess the efficacy and cortical activity impact of a dual-target electrical stimulation approach combining tDCS and TENS in the treatment of KOA after stroke. We hypothesized that the combination of tDCS with TENS could more effectively address KOA after stroke by enhancing brain activity through the induction of neural oscillations. To test this hypothesis, a double-blind, randomized trial was conducted with 30 participants receiving either TENS + tDCS or TENS + sham tDCS over an 8-week period, from Monday to Friday. Electroencephalograms (EEGs), Brief Pain Inventory (BPI), visual analog scale (VAS), stride length, cadence, 6-min walk test (6 MWT), knee range of motion (ROM), and quadriceps strength were collected pre- and poststimulation. Pain indicators were analyzed using -tests for continuous variables and chi-square tests for categorical variables, with repeated measures ANOVA employed to explore changes and interactions over time. For EEG analysis, paired -tests were utilized to investigate changes in brain regions before and after treatment on the affected side, with visual analysis conducted subsequently. The results indicated that the combined treatment led to significant improvements in the affected hemisphere, with significant changes observed in α1, α2, and β power. Additionally, significant group× time interaction effects were noted for BPI, VAS, stride length, cadence, and 6MWT. The study concludes that dual-target electrostimulation using tDCS combined with TENS significantly ameliorates knee joint inflammation following stroke by acting on the cerebral cortex and target organs. Chinese Clinical Trial Registry: ChiCTR2200064735.
经颅直流电刺激（tDCS）和经皮电刺激神经疗法（TENS）均因其镇痛作用而得到认可；然而，有证据表明，将它们应用于中风后的膝骨关节炎（KOA）时，其疗效存在局限性。本研究旨在评估将tDCS和TENS相结合的双靶点电刺激方法在治疗中风后KOA中的疗效及对皮质活动的影响。我们假设，tDCS与TENS联合使用可通过诱导神经振荡增强大脑活动，从而更有效地治疗中风后的KOA。为验证这一假设，我们进行了一项双盲随机试验，30名参与者在8周内（周一至周五）接受TENS + tDCS或TENS + 假tDCS治疗。在刺激前后收集脑电图（EEG）、简明疼痛量表（BPI）、视觉模拟量表（VAS）、步长、步频、6分钟步行试验（6MWT）、膝关节活动范围（ROM）和股四头肌力量。对于连续变量，使用t检验分析疼痛指标；对于分类变量，使用卡方检验分析疼痛指标，并采用重复测量方差分析来探究随时间的变化和相互作用。对于EEG分析，使用配对t检验来研究患侧治疗前后脑区的变化，随后进行视觉分析。结果表明，联合治疗使患侧半球有显著改善，α1、α2和β功率有显著变化。此外，在BPI、VAS、步长、步频和6MWT方面，观察到显著的组×时间交互效应。该研究得出结论，使用tDCS联合TENS的双靶点电刺激通过作用于大脑皮层和靶器官显著改善中风后的膝关节炎症。中国临床试验注册中心：ChiCTR2200064735。
