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

Abstract

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

CLC Number:

R493

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.

Figures/Tables 10

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References 27

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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

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

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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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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