经颅直流电刺激治疗脑卒中患者注意功能障碍的随机对照单盲研究

Transcranial direct current stimulation for the treatment of attention dysfunction in stroke patients:a randomized controlled single-blind study

目的:观察经颅直流电刺激(tDCS)对脑卒中患者注意功能障碍的康复疗效。方法:选取2018年7月至2020年4月在中山大学附属第三医院康复医学科收治的脑卒中注意功能障碍患者40例,用随机数字表法将其分为试验组(n=20)和对照组(n=20)。两组患者均给予注意功能训练,与此同时,试验组给予左前额叶背外侧皮质(DLPFC)的2.0mA阳极t DCS刺激,对照组给予tDCS伪刺激,持续4周。治疗前、治疗4周后分别采用简易智力状态检查量表(MMSE)评估两组患者的整体认知功能;采用数字符号测验(DST)、数字广度(DS)和连线测验(TMT)评估两组患者的注意功能,分析比较两组数据。结果:治疗4周后,两组患者的MMSE、DST、DS和TMT评分均较治疗前显著改善(P<0.05),且试验组的MMSE、DST、DS的倒背、TMT的B部分错误数评分均显著优于对照组,差异均具有显著性意义(P<0.05);试验组的DS的顺背、TMT的A部分错误数、时间和B部分时间评分与对照组比较,差异无显著性意义(P>0.05)。结论:tDCS可有效改善脑卒中患者的注意功能障碍,值得临床推广应用。

Objective:To observe the rehabilitation effect of transcranial direct current stimulation(tDCS)on attention dysfunction in stroke patients.Method:From July 2018 to April 2020,forty stroke patients with attention deficit were selected from the rehabilitation department of the third affiliated hospital of Sun Yat-Sen university.They were divided into experimental group(n=20)and control group(n=20)by a random number table.Attention functional training was given to the patients in both groups.At the same time,the experimental group was given 2.0 m A anode tDCS stimulation of the left dorsolateral prefrontal cortex(DLPFC),and the control group was given tDCS sham stimulation for 4 weeks.Before and after 4 weeks treatment,MMSE was used to evaluate the overall cognitive function of the two groups,digit symbol test(DST),digit span(DS)and trail making test(TMT)were used to evaluate the attention function of the two groups.The data of two groups were analyzed and compared.Result:After 4 weeks of treatment,the scores of MMSE,DST,DS,and TMT in both groups were significantly improved compared with those before treatment(P<0.05),and the scores of MMSE,DST,DS backward and TMT part B errors in the experimental group were significantly higher than those in the control group(P<0.05).The scores of DS forward and TMT part A errors,time and part B time were not statistical significance between the two groups(P>0.05).Conclusion:tDCS can effectively improve the attention dysfunction of stroke patients,and is worthy of clinical promotion and application.