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Neuromodulation of Executive Dysfunction in Patients with Acute Stroke Using Transcranial Direct Current Stimulation: Study Protocol for a Triple-Blind, Randomized Sham-Controlled Trial.
Amaya-Pascasio, Laura; García-Pinteño, José; Sánchez-Kuhn, Ana; Uceda Sánchez, Cristina; Fernández-Martín, Pilar; León Domene, José Juan; Rodríguez-Herrera, Rocio; Flores, Pilar; Martínez-Sánchez, Patricia.
Afiliación
  • Amaya-Pascasio L; Department of Neurology, Torrecárdenas University Hospital, Almería, Spain, laura.amaya.pascasio@gmail.com.
  • García-Pinteño J; Department of Psychology and Centre for Health Research (CEINSA), University of Almería, Almería, Spain.
  • Sánchez-Kuhn A; Department of Psychology and Centre for Health Research (CEINSA), University of Almería, Almería, Spain.
  • Uceda Sánchez C; Department of Psychology and Centre for Health Research (CEINSA), University of Almería, Almería, Spain.
  • Fernández-Martín P; Department of Psychology and Centre for Health Research (CEINSA), University of Almería, Almería, Spain.
  • León Domene JJ; Department of Psychology and Centre for Health Research (CEINSA), University of Almería, Almería, Spain.
  • Rodríguez-Herrera R; Department of Psychology and Centre for Health Research (CEINSA), University of Almería, Almería, Spain.
  • Flores P; Department of Psychology and Centre for Health Research (CEINSA), University of Almería, Almería, Spain.
  • Martínez-Sánchez P; Department of Neurology, Torrecárdenas University Hospital, Almería, Spain.
Cerebrovasc Dis ; 53(3): 335-345, 2024.
Article en En | MEDLINE | ID: mdl-39250901
ABSTRACT
Research on the benefits of non-invasive brain stimulation in stroke patients to improve executive functions is scarce. The objective of this study was to investigate the effectiveness of transcranial direct current stimulation (tDCS) in combination with cognitive training for the rehabilitation of executive functions in acute and subacute stroke patients as well as to explore the underlying physiological mechanisms. A triple-blinded, randomized-controlled clinical trial will be conducted involving 60 stroke patients with frontal or basal ganglia lesions and a Montreal Cognitive Assessment (MoCA) score less than 26. Participants will be randomly assigned to receive active tDCS (anode over the left dorsolateral prefrontal cortex, cathode at the right supraorbital region, 20 min at 2 mA) or sham tDCS in a 11 ratio for 10 sessions, followed by targeted executive function training. The primary efficacy outcome will be the MoCA score, while secondary outcomes will include the five-digit test (inhibitory control), the Digit Span Task (working memory), the abbreviated version of the Wisconsin Card Sorting test (cognitive flexibility), modified Rankin scale (functional state), Beck-II depression inventory, apathy evaluation scale, and the WHOQOL-BREF (quality of life), assessed immediately after the intervention and at 1, 3, 6, and 12 months post-intervention. Additionally, resting-state functional connectivity and blood biomarkers, such as neurotrophins, growth factors, and inflammatory molecules, will be evaluated before and after the intervention. This study will contribute to the investigation of the efficacy of tDCS in rehabilitating executive functions in acute and subacute stroke patients. The multidimensional approach utilized in this study, which includes analysis of resting-state connectivity and neuroplasticity-related blood biomarkers, is expected to provide insights into the underlying brain mechanisms involved in the rehabilitation of dysexecutive syndrome.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ensayos Clínicos Controlados Aleatorios como Asunto / Cognición / Recuperación de la Función / Accidente Cerebrovascular / Función Ejecutiva / Estimulación Transcraneal de Corriente Directa / Rehabilitación de Accidente Cerebrovascular Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ensayos Clínicos Controlados Aleatorios como Asunto / Cognición / Recuperación de la Función / Accidente Cerebrovascular / Función Ejecutiva / Estimulación Transcraneal de Corriente Directa / Rehabilitación de Accidente Cerebrovascular Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article Pais de publicación: Suiza