经颅直流电刺激改善偏侧空间忽略及运动功能的疗效观察

目的:探讨经颅直流电刺激(tDCS)对脑梗死后偏侧空间忽略(USN)及运动功能康复的临床疗效。方法:选取30例脑梗死后偏侧空间忽略患者,随机分为常规组和tDCS组各15例,2组均给予常规康复训练,tDCS组增加tDCS治疗,每周治疗5d,共4周。治疗前后分别采用直线二等分试验(LBT)、Albert线段划消试验(AT)、简式Fugl-Meyer运动功能评分(FMA)、改良Barthel指数评分(MBI)和MMSE量表评定患者功能。结果:治疗后,2组LBT和AT评分均较治疗前明显降低(均P<0.01);且tDCS组显著低于常规组(P<0.01)。2组的FMA、MBI和MMSE评分均明显高于组内治疗前(均P<0.001),且tDCS组的FMA和MBI评分显著高于常规组(均P<0.01);tDCS组和常规组的MMSE评分无统计学差异。结论:tDCS可有效地改善脑梗死患者的单侧空间忽视症状,同时促进患者运动功能康复。

Effect of transcranial direct current stimulation on unilateral spatial neglect and motor functions in patients with cerebral infarctions

Objective:To investigate the effect of transcranial direct current stimulation (tDCS) on unilateral spatial neglect and motor functions rehabilitation in patients with cerebral infarctions.Methods:Thirty patients were randomly divided into a routine treatment group ( n =15),and a tDCS group ( n =15).Both groups received basic routine rehabilitation therapy,and the tDCS group accepted tDCS therapy additionally (5 days per week for a total of 4 weeks).The patients in both groups were evaluated with the line bisection test (LBT),the Albert test (AT),the Fugl-Meyer assessment (FMA),the modified Barthel Index (MBI) and the MMSE scale before and after treatment.Results:After treatment for 4 weeks,the LBT and AT scores in both groups were significantly lower than those before treatment ( P < 0.001 ),and the FMA and MBI scores,and MMSE scores were significantly higher than those before treatment ( P < 0.001 ).There was significant difference in LBT and AT between two groups after treatment ( P < 0.01 ).The FMA and MBI scores in the tDCS group were significantly higher than those in the routine treatment group ( P < 0.01 ),but there was no significant difference in MMSE score between two groups after treatment ( P > 0.05 ).Conclusion:The tDCS has positive effect on the unilateral spatial neglect in patients with cerebral infarctions and can promote the rehabilitation of motor function.