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）的八分之一的情况下，颅内动脉瘤破裂的结果。发病率为每年100 000例居民6-8例。出血的总体风险约为每年1％，具体取决于伴随的危险因素和动脉瘤大小。尽管优化了诊断和治疗策略，但动脉瘤破裂后的死亡率和严重的发病率仍然不可接受。在出血后的前两周，死亡和严重发病的主要原因是大脑血管痉挛，导致缺血性梗塞，这是延迟缺血性神经系统缺陷（DIND）的主要原因。脑血管播主要是释放的血液产物和蛛网膜下腔中炎症反应的结果。最新的血管痉挛在药理学和介入方面受到治疗，成功有限。我们项目的目的是评估经颅直流电流刺激（TDC）对大脑血管痉挛的影响。我们研究小组的目前结果证明，TDCS以极性特异性的方式调节脑血流，其中调制的程度取决于应用的刺激参数。因此，似乎可行的是，TDC可能对血管痉挛及其续集产生积极影响。因此，我们的目的是评估TDC对脑血管痉挛的影响，分别对血管痉挛相关的缺血的影响。此外，如果我们能够检测到TDC对脑血管痉挛的影响，则下一步将建立具有最大反应的刺激参数。从这里开始，TDC在血管痉挛和 /或血管痉挛相关的缺血方面的有效性证明将具有很大的临床重要性，因为它将在动脉症SAH后临床相关的血管痉挛患者治疗一种新的非侵入性大道。