The Effect of Transcranial Direct Current Stimulation on Neglect Syndrome in Stroke Patients
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Objective To examine whether transcranial direct current stimulation (tDCS) applied over the posterior parietal cortex (PPC) improves visuospatial attention in stroke patients with left visuospatial neglect.Methods Patients were randomly assigned to 1 of 3 treatment groups: anodal tDCS over the right PPC, cathodal tDCS over the left PPC, or sham tDCS. Each patient underwent 15 sessions of tDCS (5 sessions per week for 3 weeks; 2 mA for 30 minutes in each session). Outcome measures were assessed before treatment and 1 week after completing the treatment.Results From pre- to post-treatment, there was an improvement in the motor-free visual perception test (MVPT), line bisection test (LBT), star cancellation test (SCT), Catherine Bergego Scale (CBS), Korean version of Modified Barthel Index (K-MBI), and Functional Ambulation Classification in all 3 groups. Improvements in the MVPT, SCT, and LBT were greater in the anodal and cathodal groups than in the sham group. However, improvements in other outcomes were not significantly different between the 3 groups, although there was a tendency for improved CBS or K-MBI scores in the anodal and cathodal groups, as compared with the sham group.Conclusion The study results indicated that the facilitatory effect of anodal tDCS applied over the right PPC, and the inhibitory effect of cathodal tDCS applied over the left PPC, improved symptoms of visuospatial neglect. Thus, tDCS could be a successful adjuvant therapeutic modality to recover neglect symptom, but this recovery might not lead to improvements in activities of daily living function and gait function.
Abstract
Objective To examine whether transcranial direct current stimulation (tDCS) applied over the posterior parietal cortex (PPC) improves visuospatial attention in stroke patients with left visuospatial neglect.Methods Patients were randomly assigned to 1 of 3 treatment groups: anodal tDCS over the right PPC, cathodal tDCS over the left PPC, or sham tDCS. Each patient underwent 15 sessions of tDCS (5 sessions per week for 3 weeks; 2 mA for 30 minutes in each session). Outcome measures were assessed before treatment and 1 week after completing the treatment.Results From pre- to post-treatment, there was an improvement in the motor-free visual perception test (MVPT), line bisection test (LBT), star cancellation test (SCT), Catherine Bergego Scale (CBS), Korean version of Modified Barthel Index (K-MBI), and Functional Ambulation Classification in all 3 groups. Improvements in the MVPT, SCT, and LBT were greater in the anodal and cathodal groups than in the sham group. However, improvements in other outcomes were not significantly different between the 3 groups, although there was a tendency for improved CBS or K-MBI scores in the anodal and cathodal groups, as compared with the sham group.Conclusion The study results indicated that the facilitatory effect of anodal tDCS applied over the right PPC, and the inhibitory effect of cathodal tDCS applied over the left PPC, improved symptoms of visuospatial neglect. Thus, tDCS could be a successful adjuvant therapeutic modality to recover neglect symptom, but this recovery might not lead to improvements in activities of daily living function and gait function.
참고문헌 (22)
- Pierce SR, "Treatments of unilateral neglect:a review", Arch Phys Med Rehabil, 83, pp.256~268 (2002)
- Tomaiuolo F, "Selective visual neglect in right brain damaged patients with splenial interhemispheric disconnection", Exp Brain Res, 206, pp.209~217 (2010)
- Arene NU, "Rehabilitation of unilateral spatial neglect and neuroimaging", Eura Medicophys, 43, pp.255~269 (2007)
- Yang NY, "Rehabilitation interventions for unilateral neglect after stroke: a systematic review from 1997 through 2012", Front Hum Neurosci, 7, pp.187~ (2013)
- Bowen A, "Spatial neglect: is rehabilitation effective?", Stroke, 33, pp.2728~2729 (2002)
- van Wyk A, "The effect of visual scanning exercises integrated into physiotherapy in patients with unilateral spatial neglect poststroke: a matched-pair randomized control trial", Neurorehabil Neural Repair, 28, pp.856~873 (2014)
- Edwards D, "Modulating the healthy and affected motor cortex with repetitive transcranial magnetic stimulation in stroke: development of new strategies for neurorehabilitation", NeuroRehabilitation, 23, pp.3~14 (2008)
- Fierro B, "Improving neglect by TMS", Behav Neurol, 17, pp.169~176 (2006)
- Kim BR, "Effect of high- and low-frequency repetitive transcranial magnetic stimulation on visuospatial neglect in patients with acute stroke: a double-blind, sham-controlled trial", Arch Phys Med Rehabil, 94, pp.803~807 (2013)
- Sparing R, "Bidirectional alterations of interhemispheric parietal balance by non-invasive cortical stimulation", Brain, 132(Pt 11), pp.3011~3020 (2009)
- Dambeck N, "Interhemispheric imbalance during visuospatial attention investigated by unilateral and bilateral TMS over human parietal cortices", Brain Res, 1072, pp.194~199 (2006)
- Gandiga PC, "Transcranial DC stimulation (tDCS): a tool for double-blind shamcontrolled clinical studies in brain stimulation", Clin Neurophysiol, 117, pp.845~850 (2006)
- Antal A, "Direct current stimulation over V5 enhances visuomotor coordination by improving motion perception in humans", J Cogn Neurosci, 16, pp.521~527 (2004)
- Schenkenberg T, "Line bisection and unilateral visual neglect in patients with neurologic impairment", Neurology, 30, pp.509~517 (1980)
- Azouvi P, "Behavioral assessment of unilateral neglect: study of the psychometric properties of the Catherine Bergego Scale", Arch Phys Med Rehabil, 84, pp.51~57 (2003)
- Sunwoo H, "Effects of dual transcranial direct current stimulation on post-stroke unilateral visuospatial neglect", Neurosci Lett, 554, pp.94~98 (2013)
- Liebetanz D, "Pharmacological approach to the mechanisms of transcranial DC-stimulation-induced after-effects of human motor cortex excitability", Brain, 125(Pt 10), pp.2238~2247 (2002)
- Wassermann EM, "Recharging cognition with DC brain polarization", Trends Cogn Sci, 9, pp.503~505 (2005)
- Fritsch B, "Direct current stimulation promotes BDNF-dependent synaptic plasticity: potential implications for motor learning", Neuron, 66, pp.198~204 (2010)
- Schweid L, "Cathodal transcranial direct current stimulation on posterior parietal cortex disrupts visuo-spatial processing in the contralateral visual field", Exp Brain Res, 186, pp.409~417 (2008)
- Hummel FC, "Non-invasive brain stimulation:a new strategy to improve neurorehabilitation after stroke?", Lancet Neurol, 5, pp.708~712 (2006)
- Kinsbourne M, "Hemi-neglect and hemisphere rivalry", Adv Neurol, 18, pp.41~49 (1977)