Effect of cathodal transcranial direct current stimulation on upper limb motor function in patients with stroke / 中国脑血管病杂志

ABSTRACT

Objective To investigate the effect of cathodal transcranial direct current stimulation (ctDCS)on upper limb motor function in patients with stroke. Methods From July 2016 to February 2017,45 patients with first-ever stroke hemiplegia treated with rehabilitation at the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were enrolled prospectively. Their course of disease was 1 -6 months. They were randomly divided into a 1. 0 mA group,a 2. 0 mA group,and a control group (n =15 in each group)according to the random number table. The 3 groups of patients received traditional rehabilitation training,2 times a day,once for 45 min,5 days a week for 2 weeks. On this basis,the 1. 0 mA group and 2. 0 mA group were treated with 1. 0 mA and 2. 0 mA ctDCS for two weeks,once a day,once for 20 min,5 days a week at the same time,while the control group was only treated with sham stimulation. The upper limb function was evaluated before treatment and 2 weeks after treatment. Fugl-Meyer Assessment (FMA)score and Action Research Arm Test (ARAT)were used to assess the upper limb motor function. The modified Barthel index (MBI)was used to evaluate the activities of daily living. Paired t test was used to compare before and after treatment in the groups. Single factor analysis of variance was used to compare between the groups. Results (1)There were no significant differences in the upper limb FMA score, ARAT score,and MBI score before treatment among the three groups of patients (all P >0. 05). Two weeks after treatment,the upper limb FMA score,ARAT score,and MBI score of the patients in the 3 groups were significantly improved compared with those in the same groups before treatment. The differences in the 1. 0 mA group were 12 ±3,10 ±2,and 22 ±9,respectively,those in the 2. 0 mA group were 12 ±3,10 ±3, and 20 ±6,respectively,and those in the control group were 9 ±3,7 ±3,and 18 ±7,respectively in control group (all P <0. 01). (2)Two weeks after treatment,the upper limb FMA scores and ARAT scores in the 1. 0 mA group and 2. 0 mA group were superior to the control group (the FMA scores all P < 0. 01 and ARAT scores all P <0. 05),while there was no significant difference in scores between the 1. 0 mA group and 2. 0 mA group (P > 0. 05). The were no significant differences in the MBI scores among the three groups (P >0. 05). Conclusion Cathodal transcranial direct current stimulation may have a trend of improving the upper limb motor function and promote the improvement of activity of daily living in patients with stroke,however,there was no significant difference in treatment effect of ctDCS intensity between the 1. 0 mA and 2. 0 mA treatment.