经颅直流电刺激对非流利型原发性进行性失语症语言功能的作用.pdf

Chinese Journal of Rehabilitation Medicine, Nov 2015, Vol. 30. No. 1
临床研究
经颅直流电刺激对非流利型原发性进行性失语症
语言功能的作用
汪洁吴东宇4袁英陈滟
摘要
目的:明确经颅直流电刺激(DCS)对非流利型原发性进行性失语症(PPA)患者语言功能和皮质激活的作用。
方法:采用A1-B1-A2-B2设计,对1例发病5年的非流利型原发性进行性失语症患者进行假刺激5d(A期),tDCS5d
治疗(B期),分别在假刺激、tDCS治疗前后对患者进行听觉词图匹配、图命名、词朗读、三字词复述检査。阳极
tDCS上午刺激左外侧裂后部周围区(PPR),下午刺激左 Broca区,阴极位于阳极刺激部位对侧肩部,刺激强度
1.1mA,每次20min。在A1前和BI、B2后进行脑电检査,计算非线性分析的近似熵。
结果:阳极tDCS治疗前患者的词汇听理解、图命名、词朗读、词复述严重受损,B1期治疗后,患者的上述检查成绩显
著提高(P<0.05),B2期治疗前后比较,未见明显变化,DCS治疗后刺激区和非刺激区的近似熵指数显著増高。
结论:应用阳极tDCS刺激左 Broca区和PPR区可以在短期内(5d)较大幅度地提高该例非流利型原发性进行性失语
症患者的词汇理解、图命名、词朗读、词复述功能。tDCS可能成为原发性进行性失语症的可选治疗手段。
关键词腑刺激;原发性进行性失语症;脑电描记术
中图分类号:R454.1,R743文献标识码:A文章编号:1001-1242(2015)-11-111206
Effects of transcranial direct current stimulation on language improvement in nonfluent primary progres
sive aphasia/WANG Jie, WU Dongyu, YUAN Ying, et al./Chinese Journal of Rehabilitation Medicine
2015,3011):1112-1117
Abstract
Objective: To investigate the effect of transcranial direct current stimulation( DCS)on language improvement
and cortical activation in nonfluent primary progressive aphasia(PPA)
Method: An AL-B1-A2-B2 design was used in the study. Sham stimulation was administered in phase A for
5d, and anodal TDCS was implemented for 5d in phase B in a female patient with nonfluent PPA, Each days
TD S included two sessions: anodal TDCS over left posterior perisylvian region(PPR) on the morning and left
Broca area on the afternoon The auditory word-picture identification, picture naming, word reading, and word
repetition were measured with psycholinguistic assessment in Chinese aphasia(PACA) before and after each
phase. The EEG nonlinear index of approximate entropy (Apen was calculated before phase A1, and after
phases BI and B2
Result: The patient exhibited severe impairments in auditory word-picture identification, picture naming, word
reading, and word repetition before phase B treatment. The accuracy of four subtests improved significantly af-
ter phase BI (P<0. 05) No significant difference was found in the comparison post-b2 vs. pre-b2. Apen indi
ces increased in stimulated areas and non-stimulated areas
DOL:10.39699,issa.1001-1242.2015.11.005
基金项目:国家自然科学基金资助课题(30600186;811101);首都临床特色应用研究(Z121107001012144);国家科技支撑计划
(2013BAH14FO3);海淀区社会事业研发专项项日(S2013013)
1首都医科大学宣武医院康复医学科,北京,100053;:2中日友好医院康复医学科;3北京市中关村医院康复医学科;4通讯作者
作者简介:汪洁,女,硕士,副主仃治疗师;收稿日期:2015-01-05
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