Advances in experimental medicine and biology · 2018
Cerebral Hemodynamics After Transcranial Direct Current Stimulation (tDCS) in Patients with Consequences of Traumatic Brain Injury.
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Trofimov Alexey O, Kalentiev George, Karelsky Michael, Ksenofontova Cristina, Ruzavina Alevtina, Yuriev Michail, Bragin Denis E
Аннотация
UNLABELLED: In recent years, hopes for better treatment of traumatic brain injury (TBI) have focused on non-pharmacologic transcranial electrical brain stimulation; however, studies of perfusion changes after stimulation are few and contradictory. Therefore, the aim of this study was to assess cerebral perfusion after high-definition transcranial direct current stimulation (HD-tDCS) in patients with posttraumatic encephalopathy (PTE).
METHODS: Twenty patients with PTE (16 men and 4 women, aged 35.5 ± 14.8 years) underwent perfusion computed tomography (PCT), followed by anodal HD-tDCS and post-stimulation tomography at 21 days after TBI. The Westermark perfusion maps were constructed and quantitative perfusion parameters calculated. Significance was preset to P < 0.05.
RESULTS: Qualitative analysis revealed that all patients had areas with reduced cerebral blood flow (CBF) and increased average mean transit time (MTT). HD-tDCS was accompanied by a significant decrease in the number of zones of both hypoperfusion and ischemia (p < 0.05). Quantitative analysis showed that, in all patients, HD-tDCS caused a significant increase in CBF (p < 0.001), cerebral blood volume (CBV) (p < 0.01) and MTT shortening (p < 0.05) in the frontotemporal region on the anode side. In the basal ganglia, a significant increase in CBF was found only in the five patients in whom this was initially reduced (p < 0.01) and only with an anode placed on the same side.
CONCLUSIONS: In patients with complications due to PTE TBI, HD-tDCS causes a significant increase in CBV, CBF and a decrease in the average MTT, suggesting better oxygen delivery to tissue.
METHODS: Twenty patients with PTE (16 men and 4 women, aged 35.5 ± 14.8 years) underwent perfusion computed tomography (PCT), followed by anodal HD-tDCS and post-stimulation tomography at 21 days after TBI. The Westermark perfusion maps were constructed and quantitative perfusion parameters calculated. Significance was preset to P < 0.05.
RESULTS: Qualitative analysis revealed that all patients had areas with reduced cerebral blood flow (CBF) and increased average mean transit time (MTT). HD-tDCS was accompanied by a significant decrease in the number of zones of both hypoperfusion and ischemia (p < 0.05). Quantitative analysis showed that, in all patients, HD-tDCS caused a significant increase in CBF (p < 0.001), cerebral blood volume (CBV) (p < 0.01) and MTT shortening (p < 0.05) in the frontotemporal region on the anode side. In the basal ganglia, a significant increase in CBF was found only in the five patients in whom this was initially reduced (p < 0.01) and only with an anode placed on the same side.
CONCLUSIONS: In patients with complications due to PTE TBI, HD-tDCS causes a significant increase in CBV, CBF and a decrease in the average MTT, suggesting better oxygen delivery to tissue.