左背外侧前额叶阳极经颅直流电刺激对脑卒中后抑郁症的疗效观察

关键词：经颅直流电刺激  抑郁症  脑卒中  日常生存质量

Keywords:transcranial direct current stimulation  depression  stroke  daily life quality

摘要：

      摘要 目的：观察左背外侧前额叶阳极经颅直流电刺激对脑卒中后抑郁症的疗效。 方法：将40例脑卒中患者随机分成治疗组与对照组各20例，观察治疗4周。治疗组在常规康复治疗的基础上在第1周及第2周每日增加阳极经颅直流电刺激左背外侧前额叶治疗，对照组只进行常规的康复治疗训练。在经颅直流电刺激介入前及第1周、第2周、第4周后分别应用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、改良Barthel指数（MBI）、工具性日常生活能力量表（IADL）评定患者心理及日常生活能力改善效果。 结果：治疗组患者经颅直流电刺激（tDCS）治疗1周、2周后的HAMA、HAMD评分均明显低于对照组，而且差异具有显著性意义（P<0.05）；且在刺激结束2周后的随访对比中明显要优于对照组。 结论：阳极经颅直流电刺激左背外侧前额叶对脑卒中后抑郁症可减轻或消除脑卒中患者的抑郁或者焦虑情绪，提高患者的日常生存质量。

Abstract:

      Abstract Objective: To observe the effect of anodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex on depression after stroke. Method: Forty depression stroke patients were randomly divided into treatment group and control group in a four weeks program. Besides the routine rehabilitation therapy，treatment group accepted transcranial direct current stimulation daily in the first 2 weeks. The control group accepted routine rehabilitation training only. Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), modified Barthel index (MBI), instrumental daily life ability scale (IADL) were used to evaluate the patient's psychological state and daily life ability at the end of 0,1,2,4 week of the course. Result: The treatment group patients after 1 and 2 weeks treatment with the tDCS stimulated, Hamilton anxiety rating scale and Hamilton depression rating scale were significantly lower than the control group(P<0.05);And after two weeks follow up,the scores of the assessments were still better in the treatment group than the control group. Conclusion: Anodal transcranial direct current stimulation over left dorsolateral prefrontal cortex in patients with depression after stroke can reduce their depression or anxiety, and improve their daily life quality.