Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke
Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke
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DOI：
10.1093/brain/awh369
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发表时间：
2005-03-01
期刊：
影响因子：
14.5
通讯作者：
Cohen, LG
中科院分区：
文献类型：
--
作者：
Hummel, F;Celnik, P;Cohen, LG
中风是成人运动障碍的主要原因。尽管最近取得了进展，但中风后运动功能的恢复通常是不完全的。这项双盲、假手术对照、交叉研究旨在检验运动皮层的非侵入性刺激可以改善慢性卒中患者麻痹手的运动功能的假设。使用Jebsen-Taylor手功能测试（JTT）测量手功能，JTT是一种广泛使用的，经过充分验证的功能运动评估测试，反映了日常生活活动。无创经颅直流电刺激（tDCS）可显著改善麻痹手的JTT，但假手术则无此效果，假手术的效果持续时间超过刺激期，存在于每例受试患者中，且与受累半球内运动皮质兴奋性增加相关，表现为募集曲线（RC）增加和短间期皮质内抑制减少。这些结果证明了非侵入性皮层刺激对一组手部功能的有益作用，这些功能模仿慢性卒中患者瘫痪手部的日常生活活动，并表明这种干预策略与常规康复治疗相结合可能在神经康复中发挥辅助作用。
Stroke is a leading cause of adult motor disability. Despite recent progress, recovery of motor function after stroke is usually incomplete. This double blind, Sham-controlled, crossover study was designed to test the hypothesis that non-invasive stimulation of the motor cortex could improve motor function in the paretic hand of patients with chronic stroke. Hand function was measured using the Jebsen-Taylor Hand Function Test (JTT), a widely used, well validated test for functional motor assessment that reflects activities of daily living. JTT measured in the paretic hand improved significantly with non-invasive transcranial direct current stimulation (tDCS), but not with Sham, an effect that outlasted the stimulation period, was present in every single patient tested and that correlated with an increment in motor cortical excitability within the affected hemisphere, expressed as increased recruitment curves (RC) and reduced short-interval intracortical inhibition. These results document a beneficial effect of non-invasive cortical stimulation on a set of hand functions that mimic activities of daily living in the paretic hand of patients with chronic stroke, and suggest that this interventional strategy in combination with customary rehabilitative treatments may play an adjuvant role in neurorehabilitation.