设为首页收藏本站
CopyRight 2012-2014 DS文库版权所有
外2013经颅直流电刺激(tDCS)和慢性卒中的机器人实践:时间的维度。
(0 次评价)209 人阅读0 次下载
NeuroRehabilitation 33 (2013) 49–56 DOI:10.3233/NRE-130927 IOS Press 49 Transcranial direct current stimulation (tDCS) and robotic practice in chronic stroke: The dimension of timing V. Giacobbea, H.I. Krebsb, B.T. Volpec, A. Pascual-Leoned,e, A. Rykmana, G. Zeiaratia, F. Fregnid,f, L. Dipietrob, G.W. Thickbroomg and D.J. Edwardsa,d,g, aBurke-Cornell Medical Research Institute, White Plains, NY, US bMIT, Boston, MA, US cThe Feinstein Institute for Medical Research, Manhasset, NY, US dBerenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, US eInstitut Guttmann, Universitat Autonoma de Barcelona, Barcelona, Spain fLaboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, US gCenter for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, Australia Abstract. BACKGROUND: Combining tDCS with robotic therapy is a new and promising form of neurorehabilitation after stroke, however the effectiveness of this approach is likely to be influenced by the relative timing of the brain stimulation and the therapy. OBJECTIVE: To measure the kinematic and neurophysiological effects of delivering tDCS before, during and after a single session of robotic motor practice (wrist extension). METHODS: We used a within-subjects repeated-measurement design in 12 chronic (>6 months) stroke survivors. Twenty minutes of anodal tDCS was delivered to the affected hemisphere before, during, or after a 20-minute session of robotic practice. Sham tDCS was also applied during motor practice. Robotic motor performance and corticomotor excitability, assessed through transcranial magnetic stimulation (TMS), were evaluated pre- and post-intervention. RESULTS: Movement speed was increased after motor training (sham tDCS) by 20%. Movement smoothness was improved when tDCS was delivered before motor practice (15%). TDCS delivered during practice did not offer any benefit, whereas it reduced speed when delivered after practice (10%). MEPs were present in 50% of patients at baseline; in these subjects motor practice increased corticomotor excitability to the trained muscle. CONCLUSIONS: In a cohort of stroke survivors, motor performance kinematics improved when tDCS was delivered prior to robotic training, but not when delivered during or after training. The temporal relationship between non-invasive brain stimulation and neurorehabilitation is important in determining the efficacy and outcome of this combined therapy. Keywords: tDCS, TMS, stroke, robotic training, timing Address for correspondence: Dylan Edwards. E-mail: dje2002 @med.cornell.edu. 1. Introduction Two promising modern approaches to chronic stroke rehabilitation are modulation of brain function by non- invasive brain stimulation, such as with transcranial 1053-8135/13/$27.50 2013 – IOS Press and the authors. All rights reserved

打分:

0 星

用户评论:

小黑喵
于 2019-12-25 上传
分享的是美德,收获的是知识! 加入分享吧 立即注册

  鄂ICP备18026110  鄂公网安备 42018502002448号脑文库

1513904263 400-800-8888

Powered by Discuz! X3.2 © 2001-2013 Comsenz Inc.

返回顶部