Impact of transcranial direct current stimulation (tDCS) on cerebral vasospasm after subarachnoid hemorrhage (SAH) in an experimental rat model.

经颅直流电刺激（tDCS）对实验性大鼠模型蛛网膜下腔出血（SAH）后脑血管痉挛的影响。

• 批准号: 258153529
• 负责人: Professorin Dr. Dorothee Mielke
• 金额: --
• 依托单位: Klinik für Neurochirurgie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2014
• 资助国家: 德国
• 起止时间: 2013-12-31 至 2017-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/258153529?language=en
• 关键词: Impact; transcranial; direct; current; stimulation

An acute, non-traumatic subarachnoid hemorrhage (SAH) is in eight out of ten cases the result of a ruptured intracranial aneurysm. The incidence is 6-8 cases per 100 000 residents per year. The overall annual risk of bleeding is approximately 1% / year, depending on accompanying risk factors and the aneurysm size. Despite an optimization of diagnostic and treatment strategies, the mortality and severe morbidity after an aneurysm rupture is still unacceptably high. In the first two weeks after the bleeding, the major cause of death and severe morbidity is the cerebral vasospasm, leading to ischemic infarctions, which are the major cause for delayed ischemic neurological deficits (DIND). Cerebral vasospasms are predominantly the result of released blood products and an inflammatory reaction in the subarachnoid space. Up to date, vasospasm is treated pharmacologically and interventionally with limited success. Aim of our project is to evaluate the effects of transcranial direct current stimulation (tDCS) on cerebral vasospasm after aneurysmal SAH. Current results of our research group proved that tDCS modulates cerebral blood flow in a polarity-specific way, in which the extent of modulation depends on the stimulation parameters applied. Hence, it appears feasible, that tDCS might have a positive effect on vasospasm and its sequel. Therefore, it is our aim to evaluate the effects of tDCS on cerebral vasospasm, respectively its influence on vasospasm-associated ischemia. Furthermore, if we are able to detect an influence of tDCS on cerebral vasospasm, the establishment of stimulation parameters with maximal response will be the next step. Herefrom, the proof of efficacy of tDCS on vasospasm and / or vasospasm-related ischemia would be of substantial clinical importance, because it would open a new noninvasive avenue in the treatment of patients with clinically relevant vasospasm after aneurysmal SAH.

急性非创伤性蛛网膜下腔出血(SAH)在十分之八的病例中是由颅内动脉瘤破裂引起的。发病率为每年每10万居民6-8例。根据伴随的危险因素和动脉瘤的大小，总的年出血风险约为1%/年。尽管诊断和治疗策略得到了优化，但动脉瘤破裂后的死亡率和严重发病率仍然高得令人无法接受。在出血后的头两周内，脑血管痉挛是导致死亡和严重并发症的主要原因，导致缺血性脑梗塞，这是迟发性缺血性神经功能障碍(DIND)的主要原因。脑血管痉挛主要是蛛网膜下腔血液产物释放和炎症反应的结果。到目前为止，血管痉挛的治疗主要是药物治疗和干预，但效果有限。本课题的目的是评价经颅直流电刺激对动脉瘤性蛛网膜下腔出血后脑血管痉挛的影响。我们课题组目前的研究结果证明，tDCs以一种特定于极性的方式调节脑血流，其中调节的程度取决于所应用的刺激参数。因此，tDCs可能对血管痉挛及其后遗症有积极作用，这是可行的。因此，我们的目的是评价tDCs对脑血管痉挛的作用，以及它对血管痉挛相关缺血的影响。此外，如果我们能够检测到tDCs对脑血管痉挛的影响，下一步将是建立具有最大反应的刺激参数。因此，证明tDCs对血管痉挛和/或血管痉挛相关缺血的疗效具有重要的临床意义，因为它将为临床相关的动脉瘤性蛛网膜下腔出血后血管痉挛的治疗开辟一条新的无创途径。