| Objective: To observe the effects of transcranial direct current stimulation (tDCS) on upper limb function and cortical activation in stroke patients under functional near-infrared spectroscopy (fNIRS) monitoring. Methods: Totally, 60 patients with upper limb dysfunction due to stroke were selected and randomly divided into an observation group and a control group, with 30 cases in each group. The control group received conventional rehabilitation training along with bilateral tDCS sham stimulation, while the observation group received conventional rehabilitation training combined with bilateral tDCS treatment. In the observation group, the anode was placed over the primary motor cortex (M1) of the affected hemisphere, and the cathode was placed over the M1 of the unaffected hemisphere, with a treatment duration of 4 weeks. Both groups were assessed before and after treatment using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) to evaluate upper limb function, the Modified Barthel Index (MBI) to evaluate activities of daily living, and functional near-infrared spectroscopy (fNIRS) to measure oxygenated hemoglobin (HbO2) concentration in the bilateral M1, bilateral supplementary motor area (SMA), and bilateral premotor cortex (PMC). Results: After 4 weeks of treatment, both groups showed significant increases in FMA-UE and MBI scores compared to before treatment (P<0.05), with the observation group showing significantly higher increases than the control group (P<0.05). After 4 weeks of treatment, the HbO2 concentrations in the M1, SMA, and PMC on the unaffected side decreased significantly in both groups (P<0.05), with a more pronounced decrease in the observation group than the control group (P<0.05). Additionally, the HbO2 concentrations in the M1, SMA, and PMC on the affected side increased significantly in both groups (P<0.05), with a more pronounced increase in the observa-tion group than the control group (P<0.05). Conclusion: The application of anodal tDCS to the affected side and cathodal tDCS to the healthy side can enhance the excitability of the affected side’s M1, SMA, and PMC in stroke patients with upper limb dysfunction, while reducing the excitability of the healthy side’s brain regions, thereby promoting the recovery of upper limb function. |
