TARGETED TRANSCRANIAL ELECTROTHERAPY SYSTEM TO ACCELERATE STROKE RECOVERY

靶向经颅电疗系统加速中风恢复

• 批准号: 8199404
• 负责人: LUCAS C PARRA
• 金额: $ 31.98万
• 依托单位: SOTERIX MEDICAL,INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8199404
• 关键词: Accounting; Acute; Address; Adverse effects; Agreement; Algorithms; Analgesics; Anatomic Models; Anatomy; Aphasia; Area; Behavioral; Brain; Brain region; Cities; Clinical; Cognitive; Computer Simulation; Computer software; Development; Devices; Diffuse; Electric Stimulation; Electric Stimulation Therapy; Electrodes; Employee Strikes; Ensure; Faculty; Feasibility Studies; Functional Magnetic Resonance Imaging; Goals; Head; Language; Lead; Legal patent; Lesion; Letters; Licensing; Location; Marketing; Mediating; Medical; Modeling; Motor; Neuraxis; New York; New York City; Outcome; Patients; Performance; Phase; Pilot Projects; Porifera; Production; Protocols documentation; Recovery; Recovery of Function; Rehabilitation Outcome; Rehabilitation therapy; Reporting; Rest; Safety; Scalp structure; Services; South Carolina; Stroke; System; Techniques; Technology; Technology Transfer; Therapeutic; Training; Universities; central pain; clinical application; clinical efficacy; college; commercialization; cost; design; flexibility; human subject; improved; language training; neuroimaging; product development; prototype; research study; response; skills; stroke recovery; stroke rehabilitation; technology development

DESCRIPTION (provided by applicant): Transcranial Direct Current Stimulation (tDCS) with weak currents is a non-invasive, low-cost, and well tolerated technique producing lasting functional changes in the central nervous system. There is increasing evidence supporting the use of tDCS to improve stroke rehabilitation. Behavioral and therapeutic outcomes of tDCS depend on the brain areas being targeted. However, conventional approaches are limited in that they insufficiently activate the target region and/or result in unspecific stimulation throughout the entire head. To address this, High-Definition tDCS (HD-tDCS) using arrays of specifically designed electrodes has been proposed. The high-definition approach results in more focal and targeted stimulation as compared to conventional electrode montages. It allows for exceptional flexibility in designing targeted and individualized electrotherapy. When focusing on peri-lesional areas the multi-electrode high-definition approach is predicted to achieve not only more focal stimulation but importantly, also increased intensity in the peri-lesional areas with the same total currents applied to the electrodes. Thus, the high-definition approach holds promise to achieving not only safer but also stronger activation of rehabilitation targets and thus more effective rehabilitation outcomes. This project will design, prototype, and validate the first electrotherapy system optimized for stroke rehabilitation, "Rehabilitation HD-tDCS" (rHD-tDCS); moreover this system is the first to apply advanced software algorithms and existing HD-tDCS technology to leverage the presence of the lesion to guide current to precise targets in an individually optimized fashion. The main goal of this project is the focal and reliable stimulation of peri-lesional cortical targets to improve stroke rehabilitation. The efficacy of the technique will be demonstrated on improved language training in stroke patients with aphasia. Milestones for a successful Phase-1 are: 1. Automated modeling and optimization of current flows in accurate anatomical models of stroke lesions and surrounding areas. 2. Prototype of a programmable stimulation device and electrode montage optimized for targeting these stroke areas. 3. Successful rehabilitation treatment of aphasia with the rHD-tDCS device. The stimulation device and protocols developed in this project are further applicable to motor rehabilitation in stroke and other promising areas of targeted electro-therapy. PUBLIC HEALTH RELEVANCE: Electrical stimulation with small currents trough the scalp produce significant improvements in rehabilitation training, in particular the recovery of language skills after a stroke. This projects aims to developed advanced technology called Rehabilitation High-Definition transcranial Direct Current Stimulation (rHD-tDCS) which can guide therapeutic electrical currents trough multiple electrodes to brain regions involved in functional recovery while sparing the rest of the brain. This is expected to improve safety, reliability, and efficacy of stroke rehabilitation training.

描述（由申请人提供）： 采用弱电流的经颅直流电刺激（tDCS）是一种非侵入性、低成本且耐受性良好的技术，可在中枢神经系统中产生持久的功能变化。越来越多的证据支持使用tDCS改善卒中康复。tDCS的行为和治疗结果取决于靶向的大脑区域。然而，常规方法的局限性在于它们不足以激活目标区域和/或导致遍及整个头部的非特异性刺激。为了解决这个问题，已经提出了使用专门设计的电极阵列的高清tDCS（HD-tDCS）。与传统电极导联相比，高清晰度方法可产生更多的局灶性和靶向刺激。它允许在设计有针对性的和个性化的电疗异常灵活。当聚焦于病灶周围区域时，预计多电极高清晰度方法不仅可以实现更聚焦的刺激，而且重要的是，还可以在施加到电极的总电流相同的情况下增加病灶周围区域的强度。因此，高清晰度方法有望实现不仅更安全而且更强的康复目标激活，从而实现更有效的康复结果。该项目将设计，原型设计和验证首个针对中风康复优化的电疗系统“康复HD-tDCS”（rHD-tDCS）;此外，该系统是第一个应用先进软件算法和现有HD-tDCS技术的系统，以利用病变的存在，以个性化优化的方式将电流引导到精确的目标。该项目的主要目标是病灶周围皮质靶点的聚焦和可靠刺激，以改善卒中康复。该技术的有效性将在改善中风失语患者的语言训练中得到证明。成功的第一阶段的关键是：1。在中风病变和周围区域的精确解剖模型中自动建模和优化电流。2.针对这些卒中区域优化的可编程刺激器械和电极导联的原型。3.使用rHD-tDCS设备成功康复治疗失语症。本项目中开发的刺激装置和方案进一步适用于中风运动康复和其他有前景的靶向电疗领域。 公共卫生关系： 通过头皮的小电流电刺激在康复训练中产生显着的改善，特别是中风后语言技能的恢复。该项目旨在开发名为康复高清晰度经颅直流电刺激（rHD-tDCS）的先进技术，该技术可以通过多个电极将治疗电流引导到参与功能恢复的大脑区域，同时保留大脑的其他部分。这有望提高中风康复训练的安全性、可靠性和有效性。