健侧半球经颅直流电刺激对亚急性期非流利性卒中后失语患者的治疗效果  

THERAPEUTIC EFFECT OF TRANSCRANIAL DIRECT CURRENT STIMULATION OVER THE CONTRALESIONAL HEMISPHERE ON SUBACUTE NON-FLUENT POST-STROKE APHASIA

作　　者：刘晓蔚 王强[1] 柏广涛[1] 王玉阳[1] 张子青[1] 李展菲[1] LIU Xiaowei;WANG Qiang;BAI Guangtao;WANG Yuyang;ZHANG Ziqing;LI Zhanfei(Department of Rehabilitation Medicine,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院康复医学科,山东青岛266003

出　　处：《精准医学杂志》2023年第3期245-248,253,共5页Journal of Precision Medicine

基　　金：山东省自然科学基金面上项目(ZR2020MH282)。

摘　　要：目的 探讨健侧半球经颅直流电刺激(tDCS)对亚急性期非流利性卒中后失语(post stroke aphasia, PSA)的治疗效果。方法 选取2020年6月—2021年9月于青岛大学附属医院西海岸院区康复医学科住院的亚急性期非流利性PSA患者58例,随机分为阳极刺激组(19例)、阴极刺激组(20例)和假刺激组(19例),在常规语言治疗基础上同步实施tDCS,每天1次,每周治疗5 d,共治疗3周。在治疗开始前及结束后采用西方失语症成套测试(WAB)汉化版评估患者自发语言、听理解、复述、命名、失语商(AQ),并进行比较。结果 3组患者治疗后各项WAB评分均较治疗前显著改善(t=5.349~12.220,P<0.05);阳极刺激组患者的自发语言、听理解、命名、AQ改善度方面均显著优于阴极刺激组及假刺激组(F=4.360~10.340,q=3.426~5.695,P<0.05),3组患者的复述改善度比较差异均无显著性(P>0.05)。结论 使用tDCS阳极刺激亚急性期非流利性PSA患者的右半球Broca同源区,可有效改善患者的自发语言、听理解、命名、AQ。Objective To investigate the therapeutic effect of transcranial direct current stimulation(tDCS)over the contralesional hemisphere on subacute non-fluent post-stroke aphasia(PSA).Methods A total of 58 patients with subacute non-fluent PSA who were hospitalized in Department of Rehabilitation Medicine,West Coast Campus of The Affiliated Hospital of Qingdao University,from June 2020 to September 2021 were enrolled and randomly divided into anodal stimulation group with 19 patients,cathodal stimulation group with 20 patients,and sham stimulation group with 19 patients.In addition to conventional speech therapy,tDCS was performed simultaneously once a day,5 d a week for 3 weeks.The Chinese version of Western Aphasia Battery(WAB)was used to evaluate spontaneous speech,auditory comprehension,repetition,naming,and aphasia quotient(AQ)before and after treatment.Results All three groups had significant improvements in WAB scores after treatment(t=5.349-12.220,P<0.05).Compared with the cathodal stimulation group and the sham stimulation group,the anodal stimulation group had significantly better improvements in spontaneous speech,auditory comprehension,naming,and AQ(F=4.360-10.340,q=3.426-5.695,P<0.05),and there was no significant difference in the improvement in repetition between the three groups(P>0.05).Conclusion For patients with subacute non-fluent PSA,anodal tDCS of the homologue of Broca’s area in the right hemisphere can effectively improve their spontaneous speech,auditory comprehension,naming,and AQ.

关 键 词：经颅直流电刺激 失语 语言疗法 卒中 中风康复 治疗结果 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493.2[医药卫生—临床医学]