研究慢性卒中患者单节运动前和初级运动tDCS与可能的半球间相互作用的关系。
与麻痹手对侧的M1或运动前皮层的阳极tDCS,在平衡的交叉设计中,对12例轻度手部轻瘫的慢性中风患者进行了麻痹手同侧运动前皮质的阴极tDCS和假刺激。捷成-泰勒手函数试验,评估执行日常运动任务所需的时间,被雇用。
使用Greenhouse-Geisser校正的重复测量方差分析显示了刺激类型的显着影响(因子SESSION;F(2.6,28.4)=47.3,p<0.001),相对于刺激的测试性能时间(在tDCS期间或之后;因素时间,F(1.0,11.0)=234.5,p<0.001),在刺激和相互作用SESSION*TIME后具有更高的效果(F(1.7,1.2)=30.5,p<0.001)。所有活动条件对于JTT性能的调制都是有效的,尽管M1的阳极tDCS后观察到最高的效果,其次是对麻痹手的运动前皮质的阳极刺激后的效果。根据相关模式,提出了来自另一个半球的运动前皮层对M1的抑制性输入和来自同感运动前皮层的兴奋性输入。
运动前皮层是慢性中风患者经颅非侵入性刺激的有希望的候选区域。
To investigate the effects of single-session premotor and primary motor tDCS in chronic stroke patients with relation to possible inter-hemispheric interactions.
Anodal tDCS of either M1 or premotor cortex of the side contralateral to the paretic hand, cathodal tDCS of the premotor cortex of the side ipsilateral to the paretic hand and sham stimulation were performed in 12 chronic stroke patients with mild hand paresis in a balanced cross-over design. The Jebsen-Taylor Hand Function test, evaluating the time required for performance of everyday motor tasks, was employed.
The repeated-measure ANOVA with Greenhouse-Geisser correction showed significant influence of the stimulation type (factor SESSION; F(2.6, 28.4) = 47.3, p < 0.001), the test performance time relative to stimulation (during or after tDCS; factor TIME, F(1.0, 11.0) = 234.5, p < 0.001) with higher effect after the stimulation and the interaction SESSION*TIME (F(1.7, 1.2) = 30.5, p < 0.001). All active conditions were effective for the modulation of
JTT performance, though the highest effect was observed after anodal tDCS of M1, followed by effects after anodal stimulation of the premotor cortex contralateral to the paretic hand. Based on the correlation patterns, the inhibitory input to M1 from premotor cortex of another hemisphere and an excitatory input from the ipsilesional premotor cortex were suggested.
The premotor cortex is a promising candidate area for transcranial non-invasive stimulation of chronic stroke patients.