经颅直流电刺激对卒中后运动性失语患者抑郁状态的疗效

doi:10.3969/j.issn.1006-9771.2019.11.016

《中国康复理论与实践》 ›› 2019, Vol. 25 ›› Issue (11): 1348-1351.doi: 10.3969/j.issn.1006-9771.2019.11.016

经颅直流电刺激对卒中后运动性失语患者抑郁状态的疗效

柳波, 夏扬, 黄嘉, 杨玺, 刘进, 何逸康

东南大学附属中大医院康复医学科，江苏南京市 210009

收稿日期:2019-07-20 修回日期:2019-10-17 出版日期:2019-11-25 发布日期:2019-11-21
通讯作者: 何逸康，E-mail: hantanger9162@163.com E-mail:hantanger9162@163.com
作者简介:柳波(1985-)，男，汉族，江苏邳州市人，医师，主要研究方向：神经系统疾病康复、卒中后精神障碍、神经调控。

Effects of Transcranial Direct Current Stimulation on Post-stroke Depression with Broca's Aphasia

LIU Bo, XIA Yang, HUANG Jia, YANG Xi, LIU Jin, HE Yi-kang

Rehabilitation Medicine Department of Zhongda Hospital, Southeast University, Nanjing, Jiangsu 210009, China

Received:2019-07-20 Revised:2019-10-17 Published:2019-11-25 Online:2019-11-21
Contact: HE Yi-kang, E-mail: hantanger9162@163.com E-mail:hantanger9162@163.com

摘要/Abstract

摘要： 目的评估经颅直流电刺激(tDCS)治疗卒中后运动性失语患者抑郁状态(PSD)的临床疗效和安全性。方法 2018年1月至12月，卒中后抑郁并发运动性失语患者60例随机分为对照组(n = 30)和实验组(n = 30)。两组均接受常规药物和康复治疗。实验组接受左背外侧前额叶阳极tDCS治疗，对照组接受伪刺激。治疗前，治疗后1周、2周和3周，采用医院版卒中后失语抑郁问卷(SADQ-H)、失语患者抑郁量表(ADRS)进行评定，治疗前后采用改良Barthel指数(MBI)进行评定。试验结束或退出试验时填写安全性调查表。结果对照组3例、实验组2例退出。两组SADQ-H和ADRS评分均随时间而下降(F_时间 > 100.643, P < 0.001)，实验组SADQ-H评分低于对照组(F_组别 = 6.891, P = 0.011)，ADRS两组间无显著性差异(F_组别 = 2.925, P = 0.093)，SADQ-H和ADRS评分交互效应显著(F_交互 > 13.642, P < 0.001)。实验组治疗前后MBI差值显著高于对照组(t = 7.016, P < 0.001)。两组不良反应发生率无统计学差异(P = 0.5)。结论 tDCS对卒中后抑郁并发运动性失语患者有效，无明显不良反应。

关键词: 卒中后抑郁, 运动性失语, 经颅直流电刺激

Abstract: Objective To observe the clinical efficacy and safety of transcranial direct current stimulation (tDCS) on post-stroke depression (PSD) with Broca's aphasia. Methods From January to December, 2018, 60 patients with PSD and Broca's aphasia were randomly divided into control group (n = 30) and trial group (n = 30). Both groups accepted routine medicine and rehabilitation. The trial group accepted tDCS, anode over left dorsal lateral prefrontal cortex, while the control group accepted sham stimulation. They were assessed with Stroke Aphasic Depression Questionnaire Hospital Version (SADQ-H) and Aphasic Depression Rating Scale (ADRS) before treatment and one, two and three weeks after treatment. They were also assessed with modified Barthel Index (MBI) before and three weeks after treatment. The adverse effects were investigated with questionnaire as the patients finished treatment or withdrew. Results There were three patients withdrawing in the control group, and two in the trial group. The scores of SADQ-H and ADRS decreased with time in both groups (F_time > 100.643, P < 0.001), and the score of SADQ-H was lower in the trial group than in the control group (F_group = 6.891, P = 0.011), but no significant difference was found between two groups in the scores of ADRS (F_group = 2.925, P = 0.093). There was significance of interaction between group and time (F > 13.642, P < 0.001). The difference of MBI was more in the trial group than in the control group (t = 7.016, P < 0.001). There was no significant difference in the incidence of adverse effects between the two groups (P = 0.5). Conclusion tDCS is effective on PSD in patients with Broca's aphasia, without obvious adverse effects.

Key words: post-stroke depression, Broca's aphasia, transcranial direct current stimulation

中图分类号:

R743.3

柳波, 夏扬, 黄嘉, 杨玺, 刘进, 何逸康. 经颅直流电刺激对卒中后运动性失语患者抑郁状态的疗效[J]. 《中国康复理论与实践》, 2019, 25(11): 1348-1351.

LIU Bo, XIA Yang, HUANG Jia, YANG Xi, LIU Jin, HE Yi-kang. Effects of Transcranial Direct Current Stimulation on Post-stroke Depression with Broca's Aphasia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(11): 1348-1351.

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经颅直流电刺激对卒中后运动性失语患者抑郁状态的疗效

Effects of Transcranial Direct Current Stimulation on Post-stroke Depression with Broca's Aphasia

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