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深淵なるニューロサイエンスへの旅 Vol. 75

富山大学附属病院・包括的脳卒中センターの特任講師・柴田 孝先生の論文が「Journal of Stroke and Cerebrovascular Diseases」誌に掲載されました。今回の新たな臨床試験では、脳梗塞患者に対して急性期〜回復期にかけて、両側大脳に直流電気刺激を施しながらリハビリテーションを実施することが安全であり、上肢機能の改善にも一定の効果が得られる可能性が示唆されました。今後、この研究がさらに展開することを期待しています。
https://pubmed.ncbi.nlm.nih.gov/32912556/

A Voyage to Depth of Neuroscience Vol. 75

Shibata T, Urata A, Kawahara K, Furuya K, Ishikuro K, Hattori N, Kuroda S.

Therapeutic Effects of Diagonal-Transcranial Direct Current Stimulation on Functional Recovery in Acute Stroke: A Pilot Study.

J Stroke Cerebrovasc Dis. 2020 Oct;29(10):105107. doi: 10.1016/j.jstrokecerebrovasdis.2020.105107. Epub 2020 Jul 9.
PMID: 32912556

Abstract

Background: Peak neurologic recovery from acute stroke occurs within the first 3 months, and continues at a slower pace for 6 months.

Objective/hypothesis: The aim of this pilot study is to clarify the safety and feasibility of multiple diagonal-transcranial direct current stimulation (d-tDCS) sessions up to 3 months with electrodes placed diagonally over the lesional dorsolateral prefrontal cortex and contralesional primary motor cortex for upper limb hemiparesis in acute stroke.

Methods: Five patients with acute stroke (2 with intracerebral hemorrhage and 3 with cerebral infarction) with upper limb paresis participated. d-tDCS (1 mA, 20 min per day) combined with conventional rehabilitation was given starting 7-21 days after stroke onset. Each session consisted of 10 d-tDCS over 2 weeks and patients received 2 sessions in the acute phase and 2 sessions in the subacute phase for a total 40 treatments. Motor function was assessed using Fugl-Meyer Assessment for upper extremity (FMA-UE) before and after each session, and the period to achieve 70% of maximal potential recovery in FMA-UE was evaluated.

Results: All 5 patients completed the intervention and showed no adverse effects throughout the protocol. Of these, 3 (60%) achieved 70% predicted scores within 2 months. Regarding therapeutic gains of FMA-UE in each of the 10 sessions in the acute phase, 4 sessions showed great recovery, 3 sessions showed moderate recovery, and 3 sessions showed poor recovery.

Conclusion: These findings suggest that d-tDCS over 3 months may be safe and feasible for acute stroke patients in the acute to subacute phases and have therapeutic potential to promote recovery of upper limb function, although further randomized, double-blind, sham-controlled trial is warranted with larger sample size.

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