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経頭蓋直流電気刺激が脳卒中後の神経可塑性に関連する生化学的因子に与える効果

经颅直流电刺激对脑卒中后神经可塑性相关生化因子的影响

基本信息

批准号：
19K11382
负责人：
伊藤英明
金额：
$ 2.75万
依托单位：
University of Occupational and Environmental Health, Japan
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2019
资助国家：
日本
起止时间：
2019-04-01 至 2024-03-31
项目状态：
已结题

项目摘要

脳卒中亜急性期は34症例、脳卒中慢性期の経頭蓋直流電気刺激（tDCS）の研究は9症例（クロスオーバー6症例、刺激群のみ３症例）が終了した。亜急性期脳卒中の34例については、遺伝子解析の結果、遺伝子多型(SNP)なしが7例、遺伝子多型あり群が27例であった。成熟型血清BDNF濃度は研究参加時（発症約３週間）ではSNP(-)群が20.7 ±3.3ng/ml, SNP(+)群が22.7±1.3ng/mlであり、研究参加から３週間後ではSNP(-)群が22.3±3.4ng/ml、SNP(+)群が20.8±1.2ng/mlであったが、いずれも明らかな差は認めなかった。日常生活動作について自立群（FIM≧115）と非自立群（FIM＜115）での血清成熟型BDNF濃度の比較では、研究参加時（発症約３週間）自立群（4例）が24.5±2.2ng/ml、非自立群（29例）が21.7±1.4ng/mlであった。さらに３週間後では自立群（8例）が22.8±2.0ng/ml、非自立群(25例)が20.6±1.4ng/mlであった。どちらの時点でも自立群の血清成熟型BDNF濃度が高い傾向にあったが、有意差は認めなかった。また研究参加時（発症約３週間）のSNP(-)群はFIMが85.1±9.2点、SNP(+)群では80.5±4.9とSNP(-)群のADLの平均が高く、さらに３週間後でもSNP(-)群はFIMが98.9±9.3点、SNP(+)群では94.3±4.6と同様の傾向であった。麻痺側上肢のFugl-Meyer Assessment(FMA)では研究参加時（発症約３週間）ではSNP(-)群は43.7±8.5、SNP(+)群では41.3±5.1、さらに３週間後ではSNP(-)群は50.4±6.8、SNP(+)群では47.6±4.9と両時点においてSNP(-)群の平均が高い結果であった。

The study of cerebral direct current stimulation (tDCS) in acute stroke was completed in 34 cases and chronic stroke in 9 cases (6 cases and 3 cases). 34 cases of acute stroke were found to have SNP in 7 cases and SNP in 27 cases. Mature serum BDNF concentrations were 20.7 ±3.3ng/ml for SNP(-) group and 22.7±1.3ng/ml for SNP(+) group at the time of study participation (about 3 weeks after onset), and 22.3±3.4ng/ml for SNP(-) group and 20.8±1.2ng/ml for SNP(+) group at the time of study participation. A comparison of serum mature BDNF concentrations between the self-supporting group (FIM ≠ 115) and the non-self-supporting group (FIM<115) in daily life activities showed that at the time of study participation (about 3 weeks after onset), the self-supporting group (4 cases) was 24.5± 2.2 ng/ml, and the non-self-supporting group (29 cases) was 21.7± 1.4 ng/ml. After 3 weeks, the concentration of self-supporting group (8 cases) was 22.8±2.0ng/ml, and that of non-self-supporting group (25 cases) was 20.6±1.4ng/ml. The concentration of mature BDNF in serum of self-supporting group tends to be high and intentionally low. The average ADL of SNP(-) group was 85.1±9.2 points and 80.5±4.9 points at the time of study participation (about 3 weeks after onset), and the average ADL of SNP (-) group was 98.9±9.3 points and 94.3±4.6 points at the time of study participation (about 3 weeks after onset). In the Fugl-Meyer Assessment(FMA) of the paralyzed upper limb, the SNP(-) group was 43.7±8.5, the SNP(+) group was 41.3±5.1, and the SNP(-) group was 50.4±6.8, and the SNP(+) group was 47.6±4.9.