经颅直流电刺激与功能性电刺激单独或同步干预对健康青年握力及脑激活的效应比较：基于功能性近红外光谱的研究

doi:10.3969/j.issn.1006-9771.2025.10.004

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (10): 1134-1142.doi: 10.3969/j.issn.1006-9771.2025.10.004

• 专题　脑-肢体协同的功能性近红外光谱研究 • 上一篇下一篇

经颅直流电刺激与功能性电刺激单独或同步干预对健康青年握力及脑激活的效应比较：基于功能性近红外光谱的研究

王滢雅¹, 李泰标², 苏啊红², 林友益², 周鲜红², 田鹿³, 谢洪武⁴()

1.福建中医药大学中西医结合学院中西医结合研究院，福建福州市 350122
2.厦门市第五医院，福建厦门市 361101
3.江西中医药大学，江西南昌市 330004
4.南昌大学第二附属医院康复医学科，江西南昌市330008

收稿日期:2025-09-09 修回日期:2025-09-11 出版日期:2025-10-25 发布日期:2025-11-10
通讯作者: 谢洪武(1985-)，男，汉族，福建龙岩市人，博士，副主任医师、副教授，硕士研究生导师，主要研究方向：神经调控的效应及机制，E-mail： xiehongwu361@163.com
作者简介:王滢雅(2006-)，女，汉族，辽宁本溪市人，本科生。
基金资助:
1.南昌大学第二附属医院科研启动金项目(B3563);2.福建省科技计划项目(2022Y01020084);3.江西中医药大学大学生创新创业训练计划项目(202410412291X)

Effect of single or combined transcranial direct current stimulation and functional electrical stimulation on grip strength and brain activation in young healthy individuals: a functional near-infrared spectroscopy-based study

WANG Yingya¹, LI Taibiao², SU Ahong², LIN Youyi², ZHOU Xianhong², TIAN Lu³, XIE Hongwu⁴()

1. Academy of Integrated Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, China
2. The Fifth Hospital of Xiamen, Xiamen, Fujian 361101, China
3. Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330004, China
4. Department of Rehabilitation Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330008, China

Received:2025-09-09 Revised:2025-09-11 Published:2025-10-25 Online:2025-11-10
Contact: XIE Hongwu, E-mail: xiehongwu361@163.com
Supported by:
Scientific Research Startup Fund of the Second Affiliated Hospital of Nanchang University(B3563);Fujian Science and Technology Plan(2022Y01020084);Jiangxi University of Chinese Medicine Undergraduate Innovation and Entrepreneurship Training Program(202410412291X)

摘要/Abstract

摘要：

目的探讨经颅直流电刺激(tDCS)与前臂屈肌功能性电刺激(FES)单独或同时干预对健康青年人握力和大脑皮质激活的影响。
方法 2024年12月至2025年3月，招募厦门市第五医院20~23岁健康右利手青年志愿者12例，随机交叉接受单独tDCS (tDCS组)、FES (FES组)及两者同时干预(同步组)。tDCS采用双半球初级运动皮质(M1)同步刺激(左侧阳极/右侧阴极)；FES刺激右侧桡侧腕屈肌和指浅屈肌。干预前后测量等长最大握力，采用功能性近红外光谱(fNIRS)同步监测握力任务中的氧合血红蛋白(HbO₂)浓度。
结果脱落1例。握力时间效应显著(F = 3.964, P = 0.048)，事后检验显示，FES组和同步组干预后握力提高(P < 0.05)。左前额叶皮质(PFC)和左前运动及辅助运动皮质(PMC) HbO₂浓度组间效应显著(F > 3.613, P < 0.05)；事后比较，左PFC和左初级感觉皮质HbO₂浓度FES组高于同步组，左PMC和右PMC HbO₂浓度tDCS组高于同步组(均P < 0.05)。相关性分析显示，仅同步组握力变化与双侧M1 HbO₂浓度呈正相关(r > 0.694, P < 0.05)。
结论健康青年单独接受tDCS治疗主要通过调控PFC、PMC等运动相关脑区活动发挥作用，单独接受FES治疗则直接增强外周肌力输出，且可激活左PFC参与运动调控。二者同时干预通过脑-肢体协同机制实现最大握力增益，可能与神经资源利用效率优化和M1活动有关。

关键词: 脑-肢体协同调控技术, 经颅直流电刺激, 功能性电刺激, 功能性近红外光谱, 握力

Abstract:

Objective To compare the effect of transcranial direct current stimulation (tDCS), functional electrical stimulation (FES) of the forearm flexors, and their combined intervention on grip strength and cerebral cortical activation in healthy young adults.
Methods From December, 2024 to March, 2025, twelve healthy right-handed young volunteers aged 20 to 23 years were recruited from the Fifth Hospital of Xiamen. They were randomly assigned to receive tDCS alone (tDCS group), FES alone (FES group), or simultaneous tDCS-FES (Sim group) in a crossover design. For tDCS, synchronous bihemispheric stimulation of the primary motor cortex (M1) was applied (anode on the left/cathode on the right). FES was delivered to the right flexor carpi radialis and flexor digitorum superficialis muscles. Isometric maximal grip strength was measured before and after each intervention, and functional near-infrared spectroscopy (fNIRS) was used to synchronously monitor oxyhemoglobin (HbO₂) during grip strength tasks.
Results A case dropped down. The effect of time on grip strength was significant (F = 3.964, P = 0.048); Post-hoc tests revealed that grip strength significantly increased after intervention in both FES group and Sim group (P < 0.05). The effect of groups was significant on HbO₂ of the left prefrontal cortex (PFC) and left premotor and supplementary motor cortex (PMC) (F > 3.613, P < 0.05); Post-hoc tests revealed that the HbO₂ of the left PFC and left primary sensory cortex was higher in FES group than in Sim group, while the HbO₂ of the left PMC and right PMC was higher in tDCS group than in Sim group (all P < 0.05). Correlation analysis indicated that the grip strength was positively correlated with the HbO₂ of the bilateral M1 only in Sim group (r > 0.694, P < 0.05).
Conclusion For healthy young adults, tDCS alone mainly activates motor-related brain regions such as PFC and PMC, while FES alone directly enhances peripheral muscle force output and activates the left PFC to participate in motor regulation. The combined intervention achieves the maximum gain in grip strength through a brain-limb integrated regulation mechanism, which may be associated with optimization of neural resource and M1 activity.

Key words: brain-limb coordinated rehabilitation, transcranial direct current stimulation, functional electrical stimulation, functional near-infrared spectroscopy, grip strength

中图分类号:

R493

王滢雅, 李泰标, 苏啊红, 林友益, 周鲜红, 田鹿, 谢洪武. 经颅直流电刺激与功能性电刺激单独或同步干预对健康青年握力及脑激活的效应比较：基于功能性近红外光谱的研究[J]. 《中国康复理论与实践》, 2025, 31(10): 1134-1142.

WANG Yingya, LI Taibiao, SU Ahong, LIN Youyi, ZHOU Xianhong, TIAN Lu, XIE Hongwu. Effect of single or combined transcranial direct current stimulation and functional electrical stimulation on grip strength and brain activation in young healthy individuals: a functional near-infrared spectroscopy-based study[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(10): 1134-1142.

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组别	n	治疗前		治疗后
组别	n	均值	标准差	均值	标准差
tDCS组	11	255.76	86.77	265.99	82.67
FES组	11	258.37	49.35	281.59	58.57
同步组	11	267.09	50.66	288.50	43.19

效应	平方和	自由度	均方	F值	P值
组间	9465.537	2	4732.769	1.133	0.324
时间	16556.675	1	16556.675	3.964	0.048
组间×时间	1632.481	2	816.241	0.195	0.823

组别	n	时间	时间	均值差	P值	Cohen's d
tDCS组	11	治疗前	治疗后	-10.234±4.092	0.492	0.215
FES组	11	治疗前	治疗后	-23.216±9.217	0.022	0.817
同步组	11	治疗前	治疗后	-21.414±7.464	0.004	1.101

ROI	组别	治疗前		治疗后
ROI	组别	均值	标准差	均值	标准差
左PFC	tDCS组	0.013	0.043	0.019	0.050
	FES组	0.025	0.050	0.015	0.049
	同步组	0.016	0.044	-0.004	0.035
右PFC	tDCS组	0.008	0.039	0.015	0.053
	FES组	0.018	0.047	0.006	0.037
	同步组	0.007	0.045	0.007	0.035
左PMC	tDCS组	0.023	0.045	0.025	0.054
	FES组	0.022	0.063	0.003	0.067
	同步组	0.008	0.054	-0.007	0.040
右PMC	tDCS组	0.021	0.038	0.020	0.048
	FES组	0.017	0.053	0.001	0.062
	同步组	0.007	0.057	0.001	0.047
左M1	tDCS组	0.030	0.044	0.020	0.046
	FES组	0.025	0.068	-0.010	0.048
	同步组	0.013	0.062	-0.009	0.037
右M1	tDCS组	0.025	0.043	0.032	0.069
	FES组	0.019	0.055	-0.002	0.062
	同步组	0.009	0.052	-0.004	0.027
左S1	tDCS组	0.010	0.033	0.006	0.045
	FES组	0.024	0.048	-0.002	0.027
	同步组	-0.004	0.034	-0.006	0.030
右S1	tDCS组	0.010	0.028	0.010	0.042
	FES组	0.015	0.034	0.002	0.049
	同步组	-0.002	0.026	0.002	0.036

ROI	效应	平方和	自由度	均方	F值	P值
左PFC	组间	0.015	2	0.008	3.613	0.028
	时间	0.006	1	0.006	2.914	0.089
	时间×组间	0.012	2	0.006	2.902	0.056
右PFC	组间	0.002	2	0.001	0.583	0.558
	时间	0.000	1	0.000	0.098	0.754
	组间×时间	0.008	2	0.004	2.053	0.130
左PMC	组间	0.032	2	0.016	5.422	0.005
	时间	0.009	1	0.009	3.078	0.080
	组间×时间	0.006	2	0.003	1.076	0.342
右PMC	组间	0.016	2	0.008	2.982	0.052
	时间	0.005	1	0.005	1.786	0.182
	组间×时间	0.003	2	0.002	0.606	0.546
左M1	组间	0.006	2	0.003	1.150	0.324
	时间	0.008	1	0.008	2.973	0.090
	组间×时间	0.002	2	0.001	0.315	0.731
右M1	组间	0.008	2	0.004	1.412	0.252
	时间	0.001	1	0.001	0.454	0.503
	组间×时间	0.002	2	0.001	0.412	0.664
左S1	组间	0.006	2	0.003	2.230	0.112
	时间	0.003	1	0.003	2.517	0.115
	组间×时间	0.004	2	0.002	1.482	0.231
右S1	组间	0.003	2	0.001	0.942	0.393
	时间	0.000	1	0.000	0.331	0.566
	组间×时间	0.002	2	0.001	0.625	0.537

经颅直流电刺激与功能性电刺激单独或同步干预对健康青年握力及脑激活的效应比较：基于功能性近红外光谱的研究

Effect of single or combined transcranial direct current stimulation and functional electrical stimulation on grip strength and brain activation in young healthy individuals: a functional near-infrared spectroscopy-based study

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被试	性别	年龄/岁	身高/cm	体质量/kg	BMI/(kg·m^-2)
1	男	23	178	85	26.8
2	女	21	155	50	20.8
3	女	21	168	64	22.7
4	男	20	180	100	30.9
5	男	20	179	71	22.2
6	男	20	171	56	19.2
7	男	22	163	52	19.6
8	男	22	173	61	20.4
9	女	21	170	70	24.2
10	男	22	173	61	20.4
11	男	20	170	65	22.5

ROI	组别	组别	平均值差	P值	95%CI
ROI	组别	组别	平均值差	P值	上限	下限
左PFC	tDCS组	FES组	-0.004	0.491	-0.016	0.008
	tDCS组	同步组	0.011	0.052	0.000	0.021
	FES组	同步组	0.015	0.010	0.004	0.026
右PFC	tDCS组	FES组	0.000	0.954	-0.010	0.010
	tDCS组	同步组	0.004	0.372	-0.005	0.014
	FES组	同步组	0.005	0.315	-0.004	0.014
左PMC	tDCS组	FES组	0.012	0.132	-0.004	0.027
	tDCS组	同步组	0.024	< 0.001	0.011	0.037
	FES组	同步组	0.012	0.108	-0.003	0.027
右PMC	tDCS组	FES组	0.011	0.113	-0.003	0.025
	tDCS组	同步组	0.017	0.010	0.004	0.029
	FES组	同步组	0.006	0.447	-0.009	0.020
左M1	tDCS组	FES组	0.017	0.280	-0.014	0.048
	tDCS组	同步组	0.023	0.122	-0.005	0.051
	FES组	同步组	0.005	0.753	-0.028	0.038
右M1	tDCS组	FES组	0.020	0.260	-0.014	0.054
	tDCS组	同步组	0.026	0.089	-0.003	0.055
	FES组	同步组	0.006	0.698	-0.024	0.036
左S1	tDCS组	FES组	-0.003	0.733	-0.020	0.014
	tDCS组	同步组	0.013	0.096	-0.002	0.028
	FES组	同步组	0.016	0.047	0.000	0.031
右S1	tDCS组	FES组	0.002	0.841	-0.015	0.018
	tDCS组	同步组	0.010	0.160	-0.004	0.024
	FES组	同步组	0.008	0.296	-0.007	0.024

ROI	tDCS组		FES组		同步组
ROI	r值	P值	r值	P值	r值	P值
左PFC	-0.020	0.938	-0.074	0.830	0.409	0.212
右PFC	0.012	0.972	-0.357	0.281	0.251	0.457
左PMC	-0.022	0.948	-0.184	0.588	0.600	0.051
右PMC	0.168	0.622	-0.219	0.517	0.562	0.072
左M1	-0.125	0.714	-0.273	0.417	0.694	0.018
右M1	0.236	0.484	-0.258	0.443	0.752	0.008
左S1	0.116	0.733	-0.451	0.164	0.421	0.197
右S1	0.073	0.832	-0.356	0.283	0.442	0.174

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