经颅直流电刺激对卒中后失语患者视听觉通道命名的效果

Effects of Transcranial Direct Current Stimulation on Naming of Visual and Auditory Modality in Post-stroke Aphasia

目的观察经颅直流电刺激(tDCS)对恢复期卒中后失语患者视听觉通道命名能力的影响。方法 2018年3月至11月,32例恢复期卒中后失语患者随机分为对照组和实验组,各16例。实验组在左侧额下回(L-IFG)实施阳极tDCS,对照组实施假tDCS,刺激的同时行语言训练。治疗前和治疗2周后,采用西方失语症成套测试(WAB)、图片命名测试和环境声音命名测试进行评定。结果对照组15例、实验组16例完成实验。治疗后,两组WAB失语商均显著提高(t> 5.081, P <0.001),治疗前后差值两组间无显著性差异(t=1.550, P> 0.05);两组图片命名评分均明显提高(Z> 2.650, P <0.01),治疗前后差值实验组高于对照组(Z=-2.258, P <0.05);实验组WAB实物命名评分明显提高(Z=-3.239, P <0.01),治疗前后差值实验组明显高于对照组(Z=-3.008, P <0.01);实验组环境声音命名评分显著提高(t=-4.745, P <0.001),治疗前后差值实验组高于对照组(t=2.224, P <0.05);实验组WAB自发命名、WAB完成句子、WAB反应命名评分均提高(Z> 2.191, P <0.05),对照组WAB自发命名评分提高(Z=-2.376, P <0.05),治疗前后差值两组间均无显著性差异(Z <1.568, P> 0.05)。结论 tDCS阳极刺激L-IFG对视觉和听觉通道的命名能力均有改善作用,可能通过影响语义或语音加工提高命名能力。

Objective To observe the effects of transcranial direct current stimulation(tDCS)on the naming of visual and auditory modality in patients with post-stroke aphasia.Methods From March to November,2018,32 patients with post-stroke aphasia were randomly divided into control group(n=16)and treatment group(n=16).The treatment group accepted anodal-tDCS(A-tDCS)over left-inferior frontal gyrus(L-IFG)concurrent with speech training,while the control group accepted sham-tDCS.Before and two weeks after treatment,they were assessed with Western Aphasia Battery(WAB),Picture Naming Test and Environmental Sound Naming Test.Results One patient was lost in the control group.After treatment,Aphasia Quotient of WAB improved in both groups(t>5.081,P<0.001),but the difference before and after treatment was not significantly different between two groups(t=1.550,P>0.05);the Picture Naming Test score improved in both groups(Z>2.650,P<0.01),and the difference before and after treatment was more in the treatment group than in the control group(Z=-2.258,P<0.05);the object naming score of WAB improved in the treatment group(Z=-3.239,P<0.01),and the difference before and after treatment was more in the treatment group than in the control group(Z=-3.008,P<0.01);the score of Environment Sound Naming Test improved in the treatment group(t=-4.745,P<0.001),and the difference before and after treatment was more in the treatment group than in the control group(t=2.224,P<0.05).The scores of spontaneous naming,sentences complement and reaction naming of WAB improved in the treatment group(Z>2.191,P<0.05),while the score of spontaneous naming of WAB improved in the control group(Z=-2.376,P<0.05),but the differences before and after treatment were not significantly different between two groups(Z<1.568,P>0.05).Conclusion A-tDCS over L-IFG may improve the naming ability of visual and auditory modality,which may associate with semantic or phonetic processing.