经颅直流电刺激改善卒中后失语的系统综述

Effects transcranial direct current stimulation on post-stroke aphasia:a systematic review

目的系统评价经颅直流电刺激(tDCS)对卒中后失语症(PSA)的治疗作用。方法在PubMed、Web of Science、Cochrane Library、Embase、中国知网和万方数据库中检索tDCS治疗卒中后失语的相关文献,检索时间为建库至2021年12月。提取相关内容进行系统综述。结果共返回文献1026篇,最终纳入45篇,发表时间为2010年至2021年,研究对象为卒中后失语患者,主要结局指标为言语量表和各子项。大部分研究治疗组治疗后言语量表评分高于对照组,少数波士顿失语症检查中未见改善,或仅复杂语言任务有改善。tDCS能改善卒中后失语患者的复述、命名、拼写、言语流畅度等。影响患者恢复的因素可能有电极位置、电流、持续时间、强度和左侧皮质完整性。结论tDCS治疗PSA对不同语言子项均有效果;不同tDCS方案对不同语言功能的效果有所差异。

Objective To evaluate the effects of transcranial direct current stimulation(tDCS)on post-stroke aphasia(PSA).Methods Literatures about tDCS for PSA were retrieved from PubMed,Web of Science,Cochrane library,Embase CNKI and Wanfang Data,until December,2021.The contents of the author,publication time,subjects,interven‐tion methods and time,main outcome indicators and conclusions were extracted.Results A total of 1026 articles were returned and 45 articles were finally included.The publication time was from 2010 to 2021.The subjects of the study were patients with PSA.The main outcome indicators were the various speech scales and their sub-items.For most of the trials,scores of the scales were better in the experimental groups than in the control groups after treatment,and a few found little improvement in Boston Diagnostic Aphasia Examina‐tion,or only improved in complex language tasks.tDCS can improve the repetition,naming,spelling and verbal fluency of PSA patients,which might relate with electrode placement,current magnitude,duration,intensity and left cortical integrity.Conclusion tDCS is effective on different language sub-items of PSA,and various with the program of tDCS.