经颅直流电刺激联合任务导向性康复训练对脊髓损伤大鼠前肢运动障碍的效果

doi:10.3969/j.issn.1006-9771.2023.07.006

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (7): 777-781.doi: 10.3969/j.issn.1006-9771.2023.07.006

经颅直流电刺激联合任务导向性康复训练对脊髓损伤大鼠前肢运动障碍的效果

李芳¹, 霍速¹, 杜巨豹¹, 刘秀贞¹, 李小爽², 宋为群¹()

1.首都医科大学宣武医院康复医学科，北京市 100053
2.北京中医药大学第三附属医院（密云院区）康复医学科，北京市 101599

收稿日期:2023-02-03 修回日期:2023-04-19 出版日期:2023-07-25 发布日期:2023-08-30
通讯作者: 宋为群(1965-)，女，布依族，贵州都匀市人，博士，主任医师，主要研究方向：神经康复。E-mail： songwq66@126.com
作者简介:李芳(1990-)，女，汉族，山东临沂市人，博士，医师，主要研究方向：脊髓损伤的基础和临床研究。
基金资助:
国家自然科学基金项目(82102659)

Effect of transcranial direct current stimulation combined with task-oriented rehabilitation training on forelimb motor dysfunction in rats with spinal cord injury

LI Fang¹, HUO Su¹, DU Jubao¹, LIU Xiuzhen¹, LI Xiaoshuang², SONG Weiqun¹()

1. Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
2. Department of Rehabilitation Medicine, Beijing University of Chinese Medicine Third Affiliated Hospital (Miyun District), Beijing 101599, China

Received:2023-02-03 Revised:2023-04-19 Published:2023-07-25 Online:2023-08-30
Contact: SONG Weiqun, E-mail： songwq66@126.com
Supported by:
National Natural Science Foundation of China(82102659)

摘要/Abstract

摘要：

目的观察经颅直流电刺激(tDCS)联合任务导向性康复训练抓取单个小球(SPG)对C₅单侧挫伤大鼠前肢运动功能的影响。

方法 60只成年雄性Sprague-Dawley大鼠随机分为假手术组、脊髓损伤组、tDCS组、SPG组、假刺激组和tDCS+SPG组，每组各10只。假手术组仅摘除C₅椎板，其余5组利用IH脊髓打击器制备C₅半侧挫伤模型。造模后，tDCS组给予tDCS治疗，SPG组给予SPG治疗，假刺激组给予不通电流的tDCS治疗，tDCS+SPG组给予tDCS治疗和SPG治疗，脊髓损伤组和假手术组不给予任何治疗。术后4周，各组行Rearing实验、Grooming实验和运动诱发电位(MEP)检测。

结果术后4周，与脊髓损伤组比较，tDCS组和tDCS+SPG组患侧前肢Rearing评分和Grooming评分升高(P < 0.05)，tDCS+SPG组评分高于tDCS组和SPG组(P < 0.05)，SPG组Grooming评分升高(P < 0.05)；tDCS组、SPG组和tDCS+SPG组MEP振幅增加(P < 0.05)，tDCS组和tDCS+SPG组潜伏期缩短(P < 0.05)，tDCS+SPG组振幅明显高于tDCS组和SPG组(P < 0.01)。

结论 tDCS能促进脊髓损伤大鼠运动功能的恢复，与任务导向性康复训练相结合效果更佳。

关键词: 脊髓损伤, 经颅直流电刺激, 任务导向性康复训练, 运动功能, 大鼠

Abstract:

Objective To observe the effect of transcranial direct current stimulation (tDCS) combined with task-oriented rehabilitation training single pellet reaching and grasping (SPG) on the motor function of forelimb in rats with unilateral contusion of C₅ spinal cord.

Methods A total of 60 adult male Sprague-Dawley rats were randomly divided into sham operation group (sham group), spinal cord injury (SCI) group, tDCS group, SPG group, false group and tDCS+SPG group, with ten rats in each group. Only C₅ lamina was removed in the sham group, and the C₅ spinal cord contusion model was established by IH spinal cord impactor in the other five groups. The rats received tDCS in tDCS group, SPG in SPG group, tDCS without current in false group, tDCS combined with SPG in tDCS+SPG group, and no treatment in the SCI and the sham groups. The rats were evaluated with Rearing and Grooming tests, and motor-evoked potential (MEP).

Results Four weeks after operation, compared with SCI group, the scores of Rearing and Grooming increased in tDCS group and tDCS+SPG group (P < 0.05), and they were more in the tDCS+SPG group than in tDCS group and SPG group (P < 0.05); the score of Grooming increased in SPG group (P < 0.05); while the amplitude of MEP increased in tDCS group, SPG group and tDCS+SPG group (P < 0.05), and the latency shortened in tDCS group and tDCS+SPG group (P < 0.05); and the amplitude increased more in tDCS+SPG group than in tDCS group and SPG group (P < 0.01).

Conclusion tDCS could promote the recovery of motor function in rats with SCI, and the combination therapy of tDCS and task-oriented rehabilitation training is more effective.

Key words: spinal cord injury, transcranial direct current stimulation, task-oriented rehabilitation training, motor function, rats

中图分类号:

R651.2

李芳, 霍速, 杜巨豹, 刘秀贞, 李小爽, 宋为群. 经颅直流电刺激联合任务导向性康复训练对脊髓损伤大鼠前肢运动障碍的效果[J]. 《中国康复理论与实践》, 2023, 29(7): 777-781.

LI Fang, HUO Su, DU Jubao, LIU Xiuzhen, LI Xiaoshuang, SONG Weiqun. Effect of transcranial direct current stimulation combined with task-oriented rehabilitation training on forelimb motor dysfunction in rats with spinal cord injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 777-781.

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参考文献 23

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组别	n	术前	术后4周
假手术组	10	76.80±5.01	76.70±5.12
脊髓损伤组	10	75.70±6.89	30.20±3.22
tDCS组	10	75.90±7.91	41.10±3.32^a
SPG组	10	76.20±7.21	36.20±3.19
假刺激组	10	76.90±5.84	31.20±3.30
tDCS+SPG组	10	74.20±6.99	50.60±2.68^b,c,d
F值		0.214	242.410
P值		0.955	< 0.001

组别	n	术前	术后4周
假手术组	10	5.00±0.00	5.00±0.00
脊髓损伤组	10	5.00±0.00	2.80±0.60
tDCS组	10	5.00±0.00	3.76±0.28^a
SPG组	10	5.00±0.00	3.35±0.37^b
假刺激组	10	5.00±0.00	2.85±0.54
tDCS+SPG组	10	5.00±0.00	4.28±0.37^c,d,e
F值			44.120
P值			< 0.001

组别	n	潜伏期/ms	振幅/μV
假手术组	10	7.18±0.18	49.84±2.19
脊髓损伤组	10	9.20±0.27	6.37±1.32
tDCS组	10	8.09±0.42^a	17.94±1.92^b
SPG组	10	8.90±0.45	9.28±1.23^a
假刺激组	10	9.05±0.36	6.10±0.93
tDCS+SPG组	10	7.77±0.38^b	39.55±3.63^c,d,e
F值		52.440	816.341
P值		< 0.001	< 0.001

经颅直流电刺激联合任务导向性康复训练对脊髓损伤大鼠前肢运动障碍的效果

Effect of transcranial direct current stimulation combined with task-oriented rehabilitation training on forelimb motor dysfunction in rats with spinal cord injury

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