Targeted transcranial direct current stimulation for rehabilitation after stroke.
Targeted transcranial direct current stimulation for rehabilitation after stroke.
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DOI：
10.1016/j.neuroimage.2013.02.049
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发表时间：
2013-07-15
期刊：
影响因子：
5.7
通讯作者：
Parra, Lucas C.
中科院分区：
文献类型：
--
作者：
Dmochowski, Jacek P.;Datta, Abhishek;Huang, Yu;Richardson, Jessica D.;Bikson, Marom;Fridriksson, Julius;Parra, Lucas C.
经颅直流电刺激（tDCS）作为卒中后行为康复治疗的辅助技术正在研究中。传统的“剂量”，包括一个大的（25平方厘米）的阳极在目标与阴极在对侧半球，先前已被证明产生广泛分布的电场，其强度在目标区域小于最大。在这里，我们报告了一个小的“高清晰度”电极的系统靶向程序的结果，该程序用于对8例慢性失语症中风患者进行试点研究。我们使用功能性和解剖性磁共振成像（fMRI/MRI）来定义目标并分别优化（相对于目标处的电场强度）电极配置，并证明目标皮质中的电场强度可以大幅增加（63%）比传统方法。最佳蒙太奇在受试者之间以及在干扰受试者内的目标位置时表现出显著的变化。然而，对于目标坐标的每个位移，该算法能够确定向该位置输送一致量的电流的蒙太奇。这些结果表明，基于MRI的电流模型产生最大的刺激目标结构，因此，可以帮助可靠地评估疗效的tDCS在神经康复。
Transcranial direct current stimulation (tDCS) is being investigated as an ad-junctive technique to behavioral rehabilitation treatment after stroke. The conventional “dosage”, consisting of a large (25cm2) anode over the target with the cathode over the contralateral hemisphere, has been previously shown to yield broadly distributed electric fields whose intensities at the target region are less than maximal. Here, we report the results of a systematic targeting procedure with small “high-definition” electrodes that was used in preparation for a pilot study on 8 stroke patients with chronic aphasia. We employ functional and anatomical magnetic resonance imagery (fMRI/MRI) to define a target and optimize (with respect to the electric field magnitude at the target) the electrode configuration, respectively, and demonstrate that electric field strengths in targeted cortex can be substantially increased (63%) over the conventional approach. The optimal montage exhibits significant variation across subjects as well as when perturbing the target location within a subject. However, for each displacement of the target co-ordinates, the algorithm is able to determine a montage which delivers a consistent amount of current to that location. These results demonstrate that MRI-based models of current flow yield maximal stimulation of target structures, and as such, may aid in reliably assessing the efficacy of tDCS in neurorehabilitation.
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影响因子：
3.5
作者：
Dmochowski, Jacek P.;Bikson, Marom;Parra, Lucas C.
通讯作者：
Parra, Lucas C.
影响因子：
1.7
作者：
Fregni, F;Boggio, PS;Pascual-Leone, A
通讯作者：
Pascual-Leone, A
影响因子：
8.3
作者：
Fridriksson J;Richardson JD;Baker JM;Rorden C
通讯作者：
Rorden C
影响因子：
8.3
作者：
Baker JM;Rorden C;Fridriksson J
通讯作者：
Fridriksson J
影响因子：
2.5
作者：
Nitsche, M. A.;Doemkes, S.;Paulus, W.
通讯作者：
Paulus, W.