Using transcranial direct-current stimulation to treat stroke patients with aphasia.
Using transcranial direct-current stimulation to treat stroke patients with aphasia.
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DOI：
10.1161/strokeaha.109.576785
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发表时间：
2010-06
期刊：
影响因子：
8.3
通讯作者：
Fridriksson J
中科院分区：
文献类型：
--
作者：
Baker JM;Rorden C;Fridriksson J
最近的研究表明，增加左半球皮层活动，主要是左额叶皮层，与中风患者失语症（PWA）的命名能力改善有关。我们的目的是确定阳极经颅直流电刺激（a - tdcs），一种被认为可以增加皮层兴奋性的方法，当应用于左额叶皮层上的头皮时，是否会提高PWA的命名准确性。10例慢性卒中性失语症患者接受5天的a -tDCS （1 mA， 20分钟）和5天的假tDCS （S-tDCS， 20分钟，随机顺序），同时进行计算机化的失语症治疗。在公开命名任务中，使用每个个体的先验功能性MRI结果来指导tDCS定位，以确保活性电极放置在结构完整的皮层上。结果显示，与S-tDCS相比，A-tDCS显著提高了被处理项目的命名准确率（F(1,9) = 5.72, p < 0.040）。表现出最大改善的患者是那些离刺激部位最近的病灶周围区域。至关重要的是，这种治疗效果在治疗后至少持续一周。我们的研究结果表明，在左额叶皮层上的a - tdcs可以提高PWA的命名准确性，如果在更大规模的研究中证明是有效的，可能会为异常症提供一种补充治疗方法。
Recent research suggests that increased left hemisphere cortical activity, primarily of the left frontal cortex, is associated with improved naming performance in stroke patients with aphasia (PWA). Our aim was to determine if anodal transcranial direct current stimulation (A-tDCS), a method thought to increase cortical excitability, would improve naming accuracy in PWA when applied to the scalp overlying the left frontal cortex. Ten patients with chronic stroke-induced aphasia received five days of A-tDCS (1 mA; 20 min) and five days of sham tDCS (S-tDCS; 20 min, order randomized) while performing a computerized anomia treatment. tDCS positioning was guided using a priori functional MRI results for each individual during an overt naming task to ensure the active electrode was placed over structurally-intact cortex. Results revealed significantly improved naming accuracy of treated items (F(1,9) = 5.72, p < 0.040) following A-tDCS as compared to S-tDCS. Patients who demonstrated the most improvement were those with perilesional areas closest to the stimulation site. Crucially, this treatment effect persisted at least one-week post-treatment. Our findings suggest that A-tDCS over the left frontal cortex can lead to enhanced naming accuracy in PWA and, if proved to be effective in larger studies, may provide a supplementary treatment approach for anomia.