经颅直流电刺激对卒中后传导性失语症患者语言功能的治疗效果研究  

Effect of transcranial direct current stimulation on speech function in patients with conductive aphasia after stroke

作　　者：张大华[1] 宋为群[1] 张甜甜[1] 程亦男[1] 汪洁[1] 赵钰婷[1] Zhang Dahua;Song Weiqun;Zhang Tiantian;Cheng Yinan;Wang Jie;Zhao Yuting(Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院康复医学科,北京100053

出　　处：《中国脑血管病杂志》2024年第10期678-683,共6页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨经颅直流电刺激(tDCS)干预左侧大脑外侧裂后部颞顶联合区对卒中后传导性失语症患者语言功能的治疗效果。方法前瞻性连续纳入2021年6月至2024年4月在首都医科大学宣武医院康复医学科治疗的卒中后失语症患者。本研究采用自身交叉随机对照试验,入组患者经西方失语成套测验诊断标准评估为传导性失语。将12例卒中后传导性失语症患者完全随机分为A组(治疗顺序:A期—洗脱期—B期)和B组(治疗顺序:B期—洗脱期—A期),各6例。A期为tDCS真干预联合言语语言训练,B期为tDCS假干预联合言语语言训练,洗脱期仅接受言语语言训练,每期均训练5 d。tDCS阳极为刺激电极,放置于刺激靶点;阴极为参考电极,放置于右侧肩部。tDCS的强度为1.4 mA,真刺激为20 min/次,假刺激仅30 s/次后自动停止,均2次/d,共治疗10次。言语语言训练30 min/次,2次/d,共训练10次。A、B期治疗前和治疗后立即进行复述和视图命名(训练项和非训练项)功能检查,并比较A期与B期治疗前后复述和视图命名(训练项和非训练项)功能评分的差值。结果(1)A组与B组患者性别、年龄、病程、受教育程度的差异均无统计学意义(均P>0.05)。(2)康复治疗前,A组与B组患者复述和视图命名(训练项、非训练项)功能评分的差异均无统计学意义(均P>0.05)。(3)A组与B组内洗脱期治疗前后复述和视图命名(训练项、非训练项)功能评分的差异均无统计学意义(均P>0.05)。(4)与B期治疗前后的差值比较,A期患者治疗前后复述功能、视图命名(训练项)、视图命名(非训练项)功能评分的差值均较高[分别为(6.9±1.4)分比(2.2±1.0)分,t=9.604;(6.2±1.2)分比(1.8±1.1)分,t=9.277;(6.5±1.0)分比(1.5±1.0)分,t=12.247;均P<0.01]。结论初步分析显示,tDCS对左侧大脑外侧裂后部颞顶联合区脑组织的干预可能有助于改善卒中后传导性失语症患者复述和视图命名(训练项和非Objective To investigate the effect of transcranial direct current stimulation(tDCS)in the left posterior sylvia temporal-parietal association area on language function in patients with post-stroke conductive aphasia.Methods The post-stroke aphasia patients admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were prospectively included from June 2021 to April 2024.A self-cross randomized controlled trial was performed in this study.The patients enrolled were assessed as conductive aphasia by Western aphasia test kit diagnostic criteria.Twelve patients with post-stroke conductive aphasia were completely randomly divided into group A(treatment sequence:stage A—washout period—stage B)and group B(treatment sequence:stage B—washout period—stage A),with 6 cases in each group.Stage A performed true tDCS therapy combined with speech and language training,and stage B performed sham tDCS therapy combined with speech and language training.During washout period,only speech and language training was performed,and each stage was trained for 5 days.The tDCS anode is the stimulation electrode and is placed at the stimulation target.The cathode is the reference electrode and is placed on the right shoulder.The intensity of tDCS was 1.4 mA,the true stimulation was 20 min/time,and the sham stimulation stopped automatically after only 30 s/time,both twice/d,and a total of 10 times treatment were performed.Speech and language training was performed 30 min/time,2 times/d,a total of 10 times treatment.The function of rehearsal and picture naming(training item and non-training item)were examined before and after treatment of stage A and B immediately,and the difference of function scores of rehearsal and picture naming(training item and non-training item)before and after treatment of stage A and B were compared.Results(1)There were no significant differences in gender,age,course of disease and educational level between group A and group B(all P>0.05).(2)Before and after washout period

关 键 词：命名不能 失语 传导性 经颅直流电刺激 复述功能 视图命名 

分 类 号：R743.3[医药卫生—神经病学与精神病学]