Increased resting state connectivity between ipsilesional motor cortex and contralesional premotor cortex after transcranial direct current stimulation with physical therapy.
Increased resting state connectivity between ipsilesional motor cortex and contralesional premotor cortex after transcranial direct current stimulation with physical therapy.
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DOI：
10.1038/srep23271
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发表时间：
2016-03-16
影响因子：
4.6
通讯作者：
Schlaug G
中科院分区：
文献类型：
--
作者：
Chen JL;Schlaug G
在运动康复期间使用经颅直流电刺激（tDCS）对大脑进行非侵入性刺激可以改善中风患者的运动恢复。然而，神经基板的基础上的临床改善还没有得到很好的理解。在这项原则证明的开放标签试点研究中，5名中风患者在接受手臂和手部常规护理物理/职业治疗时接受了10次tDCS治疗。运动障碍指数的上半身Fugl迈耶评估干预后显着减少。干预后，同侧运动皮层和对侧运动前皮层之间的静息状态fMRI连通性增加。这些研究结果提供了初步的证据，tDCS的神经基础加上康复锻炼，可能是由运动和运动前皮质之间的相互作用介导的。后者已被证明在中风后运动恢复中发挥重要作用。我们的数据表明，运动前皮质可以作为非侵入性脑刺激的目标区域进行测试，以增强可能有利于中风运动恢复的区域之间的连接。
Non-invasive stimulation of the brain using transcranial direct current stimulation (tDCS) during motor rehabilitation can improve the recovery of movements in individuals with stroke. However, the neural substrates that underlie the clinical improvements are not well understood. In this proof-of-principle open-label pilot study, five individuals with stroke received 10 sessions of tDCS while undergoing usual care physical/occupational therapy for the arm and hand. Motor impairment as indexed by the Upper Extremity Fugl Meyer assessment was significantly reduced after the intervention. Resting state fMRI connectivity increased between ipsilesional motor cortex and contralesional premotor cortex after the intervention. These findings provide preliminary evidence that the neural underpinnings of tDCS coupled with rehabilitation exercises, may be mediated by interactions between motor and premotor cortex. The latter, of which has been shown to play an important role in the recovery of movements post-stroke. Our data suggest premotor cortex could be tested as a target region for non-invasive brain-stimulation to enhance connectivity between regions that might be beneficial for stroke motor recovery.