文章摘要
张大华,宋为群,汪洁,袁英,程亦男.不同刺激靶点经颅直流电刺激对脑卒中后运动性失语症患者动词命名疗效的比较研究[J].中国康复,2023,38(8):460-464
不同刺激靶点经颅直流电刺激对脑卒中后运动性失语症患者动词命名疗效的比较研究
A comparative study of the efficacy of transcranial direct current stimulation with different stimulation targets on verb naming in patients with motor aphasia after stroke
  
DOI:
中文关键词: 脑卒中  失语症  经颅直流电刺激  动词命名
英文关键词: stroke  aphasia  transcranial direct current stimulation  verb naming
基金项目:
作者单位
张大华 首都医科大学宣武医院康复医学科北京 100053 
宋为群 首都医科大学宣武医院康复医学科北京 100053 
汪洁 首都医科大学宣武医院康复医学科北京 100053 
袁英 首都医科大学宣武医院康复医学科北京 100053 
程亦男 首都医科大学宣武医院康复医学科北京 100053 
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中文摘要:
  目的:对比经颅直流电刺激(tDCS)刺激左侧大脑Broca区和运动区对左侧大脑额叶损伤的运动性失语症患者动词命名的疗效。方法:回顾性连续纳入2019年6月~2022年6月在首都医科大学宣武医院康复医学科住院部和门诊进行治疗的符合入组标准的失语症患者36例,将入组患者分为对照组、Broca组、M1组各12例;3组患者均接受相同时长的言语语言治疗,训练内容均为评价中的训练项图片。在此基础上,Broca组采用阳极tDCS刺激左半球Broca区,M1组为阳极tDCS刺激左半球M1区,刺激强度均1.4mA,刺激时长20min,连续治疗5d。于治疗前及治疗5d后进行动词的命名和听理解评估,其中动词命名包括训练项和非训练项动词命名。结果:治疗后,3组患者训练项动词命名成绩均较治疗前有显著提高(P<0.05),且Broca组较M1组和对照组有显著提高(P<0.05)。治疗后,Broca组非训练项动词命名成绩较治疗前有显著提高(P<0.05),且Broca组较M1组和对照组均有显著提高(P<0.05)。治疗后,Broca组动词听理解成绩较治疗前显著提高(P<0.05),且Broca组较M1组和对照组均有显著提高(P<0.05)。结论:tDCS刺激Broca区较M1区能更有效地提高左侧额叶损伤导致的失语症患者的动词理解和命名,并对动词命名的治疗效果有更好的泛化作用。
英文摘要:
  Objective: To study the effect of transcranial direct current stimulation (tDCS) at the Broca and motor areas of the left side of the brain on verb naming in aphasia patients with left frontal lobe injury. Methods: A total of 36 aphasia patients who met the inclusion criteria and underwent rehabilitation in the Department of Rehabilitation Medicine and Outpatient Department of Xuanwu Hospital, Capital Medical University from June 2019 to June 2022 were retrospectively enrolled. The patients were divided into control group, Broca group and M1 group. All patients in the three groups received the same speech and language therapy, and the training content included the treatment item pictures in the evaluation. At the same time, the left hemisphere Broca area was stimulated in Broca group, and the left hemisphere M1 area was stimulated in M1 group. The stimulation intensity was 1.4 mA, the stimulation duration was 20 min, and the treatment lasted for 5 days. Verb naming and verbal listening comprehension were evaluated before and 5 days after treatment. Verb naming included treatment and non-treatment verb naming. Results: After treatment, verb naming scores of training items in 3 groups were significantly improved as compared with those before treatment (P<0.05), and those in Broca group was significantly improved as compared with M1 group and control group (P<0.05). After treatment, the naming performance of non-training item verbs in the Broca group was significantly improved as compared with that before treatment (P<0.05), and that in the Broca group was significantly improved as compared with M1 group and control group (P<0.05). After treatment, the performance of verb listening comprehension in the Broca group was significantly improved as compared with that before treatment (P<0.05), and that in the Broca group was significantly improved as compared with the M1 group and the control group (P<0.05). Conclusion: The tDCS of the Broca region can more effectively improve verb comprehension and naming in patients with aphasia caused by left frontal lobe injury than M1 region, and has a better generalization effect on verb naming.
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