본문 바로가기
KERD
논문KCI 등재

뇌졸중 환자의 구음장애에 대한 경두개 직류 전류 자극의 효과

The Effects of Transcranial Direct Current Stimulation on Dysarthria in Stroke Patients

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류재활의학

초록

Objective: To investigate whether transcranial direct current stimulation (tDCS) can improve dysarthria in stroke patients. Method: Twelve patients who developed dysarthria after acute middle cerebral artery (MCA) infarction were included in this study. In a prospective, double blinded, randomized case control study performed between January 2007 and December 2008, six patients were randomized to anodal tDCS application and conventional speech therapy, and six patients were randomized to the sham group which received only conventional speech therapy. tDCS was delivered for 30 minutes at 2 mA with 25cm2, five times/week, for a total two weeks. The effects were assessed in maximal phonation time (MPT), alternative motion rates (AMR)-Pa, AMR-Ta, AMR-Ka, and sequential motion rates (SMR)-PaTaKa using the Multi-Media Dimension Voice Program. Results: Pre-treatment patient evaluation showed no significant difference between the two groups for all parameters. The MPT, AMR-Pa, AMR-Ta, AMR-Ka, and SMR-PaTaKa were improved pre- and post-treatment in the stimulation group, while MPT, SMR-PaTaKa were improved in the sham group (p<0.05). The AMR-Pa significantly improved in the stimulation group compared to the sham group (p<0.05). Conclusion: As these results demonstrated the beneficial effects of anodal tDCS on dysarthria, tDCS can successfully be used as a treatment modality for patients suffering from dysarthria after stroke. (J Korean Acad Rehab Med 2010; 34: 10-14)

Abstract

Objective: To investigate whether transcranial direct current stimulation (tDCS) can improve dysarthria in stroke patients. Method: Twelve patients who developed dysarthria after acute middle cerebral artery (MCA) infarction were included in this study. In a prospective, double blinded, randomized case control study performed between January 2007 and December 2008, six patients were randomized to anodal tDCS application and conventional speech therapy, and six patients were randomized to the sham group which received only conventional speech therapy. tDCS was delivered for 30 minutes at 2 mA with 25cm2, five times/week, for a total two weeks. The effects were assessed in maximal phonation time (MPT), alternative motion rates (AMR)-Pa, AMR-Ta, AMR-Ka, and sequential motion rates (SMR)-PaTaKa using the Multi-Media Dimension Voice Program. Results: Pre-treatment patient evaluation showed no significant difference between the two groups for all parameters. The MPT, AMR-Pa, AMR-Ta, AMR-Ka, and SMR-PaTaKa were improved pre- and post-treatment in the stimulation group, while MPT, SMR-PaTaKa were improved in the sham group (p<0.05). The AMR-Pa significantly improved in the stimulation group compared to the sham group (p<0.05). Conclusion: As these results demonstrated the beneficial effects of anodal tDCS on dysarthria, tDCS can successfully be used as a treatment modality for patients suffering from dysarthria after stroke. (J Korean Acad Rehab Med 2010; 34: 10-14)

참고문헌 (20)

  1. Duffy JR, "Defining, understanding, and categorizing motor speech disorders. In: Duffy JR, editor, Motor speech disorders: substrates, differential diagnosis and management", pp.3~16 (2005), Mosby
  2. Urban PP, "Dysarthria in acute ischemic stroke: lesion topography, clinicoradiologic correlation, and etiology", Neurology, 56, pp.1021~1027 (2001)
  3. Arboix A, , Stroke, 21, pp.842~847 (1990)
  4. Melo TP, "Pure motor stroke: a reappraisal", Neurology, 42, pp.789~795 (1992)
  5. Urban PP, "Impaired cortico-bulbar tract function in dysarthria due to hemispheric stroke", Brain, 120, pp.1077~1084 (1997)
  6. Sellars C HT, "Speech and language therapy for dysarthria due to non-progressive brain damage", Cochrane Database of Systemic Reviews, 4 (2009)
  7. Boggio PS, "Repeated sessions of noninvasive brain dc stimulation is associated with motor function improvement in stroke patients", Restor Neurol Neurosci, 25, pp.123~129 (2007)
  8. Hummel F, "Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke", Brain, 128, pp.490~499 (2005)
  9. Takeuchi N, "Repetitive transcranial magnetic stimulation of contralesional primary motor cortex improves hand function after stroke", Stroke, 36, pp.2681~2686 (2005)
  10. Iyer MB MU, "Safety and cognitive effect of frontal DC brain polarization in healthy individuals", Neurology, 64, pp.872~875 (2005)
  11. Priori A, "Brain polarization in humans: a reappraisal of an old tool for prolonged non-invasive modulation of brain excitability", Clin Neurophysiol, 114, pp.589~595 (2003)
  12. Nitsche MA, "Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation", J Physiol, 527, pp.633~639 (2000)
  13. Butterfish CM KV, "Enhancing encoding of a motor memory in the primary motor cortex by cortical stimulation", J Neurophysiology, 91, pp.2110~2116 (2004)
  14. Darley FL, "Differential diagnostic patterns of dysarthria", J Speech Hear Res, 12, pp.246~269 (1969)
  15. Sarno MT, "Characteristics of verbal impairment in closed head injured patients", Arch Phys Med Rehabil, 67, pp.400~405 (1986)
  16. Liebetanz D, "Pharmacological approach to the mechanisms of transcranial DC- stimulation-induced after-effects of human motor cortex excitability", Brain, 125, pp.2238~2247 (2002)
  17. Chen R, "Interactions between inhibitory and excitatory circuits in the human motor cortex", Exp Brain Res, 154, pp.1~10 (2004)
  18. Nitsche MA, "Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans", Neurology, 57, pp.1899~1901 (2001)
  19. Monti A, "Improved naming after transcranial direct current stimulation in aphasia", J Neurol Neurosurg Psychiatry, 79, pp.451~453 (2008)
  20. 고명환, "피질기저핵변성 환자에서 경두개 직류전류 자극 후 실행증 및 손기능 호전", Annals of Rehabilitation Medicine, 31(3), pp.278~282 (2007), 대한재활의학회

이 간행물의 다른 논문 (9건)