经颅直流电刺激联合镜像疗法对脑卒中患者上肢运动功能的影响

Effects of Transcranial Direct Current Stimulation and Mirror Therapy on Upper Limb Motor Function for Patients after Stroke

目的观察经颅直流电刺激(tDCS)联合镜像疗法(MT)对脑卒中患者上肢运动功能障碍的影响。方法2018年4月至2019年3月,78例脑卒中住院患者随机分为tDCS组(n=26)、MT组(n=26)和联合组(n=26),分别在常规药物治疗和康复训练的基础上增加阳极tDCS、MT和tDCS联合MT。治疗前和治疗4周后,测量患侧脑区运动诱发电位皮质潜伏期(CL)、中枢运动传导时间(CMCT),采用Fugl-Meyer评定量表上肢部分(FMA-UE)和改良Barthel指数(MBI)进行评定。结果治疗后,3组患者CL和CMCT,以及FMA-UE和MBI评分均较治疗前改善(|t|>2.609,P<0.001),联合组优于tDCS组和MT组(P<0.05)。结论tDCS和MT均可以改善脑卒中患者患侧大脑皮质兴奋性和上肢运动功能,联合应用效果更佳。

Objective To investigate the effects of combination of transcranial direct current stimulation(tDCS)and mirror therapy(MT)on upper limb motor function after stroke.Methods From April,2018 to March,2019,78 stroke inpatients were randomly assigned into tDCS group(n=26),MT group(n=26)and combined group(n=26).All the patients received their related therapy,respectively,based on routine medicine and rehabilitation.Their motor-evoked potential cortical latency(CL)and central motor conduction time(CMCT)in affected brain area were measured before and four weeks after treatment,while they were assessed with Fugl-Meyer Assessment-Upper Extremity(FMA-UE)and modified Barthel Index(MBI).Results All CL,CMCT,and the scores of FMA-UE and MBI improved significantly in all the groups after treatment(|t|>2.609,P<0.05),and improved more in the combined group than in both tDCS group and MT group(P<0.05).Conclusion Both tDCS and MT could improve excitability of cerebral cortex of the affected brain area and promote the recovery of upper limb motor function for patient after stroke,and it is more effective in combination mode.