经颅直流电刺激对卒中后失眠的疗效

doi:10.3969/j.issn.1006-9771.2022.12.012

Abstract

Abstract:

Objective To observe the effects of transcranial direct current stimulation (tDCS) on insomnia, anxiety and depression in patients with post-sroke insomnia (PSI).

Methods From January, 2020 to May, 2021, 44 patients with PSI from Beijing Bo'ai Hospital were randomly divided into control group (n = 22) and experimental group (n = 22). On the basis of conventional treatment, the experimental group accepted tDCS, and the control group accepted sham stimulation for four weeks. Pittsburgh Sleep Quality Index (PSQI) and sleep monitoring system based on cardiopulmonary coupling technology were used to evaluate the sleep quality of the patients before and after treatment. Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate mood.

Results Two cases dropped out in each group. After treatment, the scores of PSQI, HAMA and HAMD decreased in both groups (t > 8.575, P < 0.001), and the scores of PSQI and HAMA were better in the experimental group than in the control group (t > 2.811, P < 0.01), however, there was no significant difference in the scores of HAMD between two groups (t = 1.756, P > 0.05). After treatment, the sleep quality index, total sleep time, sleep latency, sleep efficiency and wake conversion times improved (|t| > 4.721, P < 0.001), and the rapid eye movement time prolonged in the experimental group (t = -2.851, P = 0.010); the sleep quality index, total sleep time, sleep efficiency and wake conversion times were better in the experimental group than in the control group (t > 2.190, P < 0.05), however, no significant difference was found in the sleep latency and rapid eye movement time between two groups (|t|< 1.073, P > 0.05).

Conclusion tDCS could improve the sleep quality and anxiety in PSI patients, and has little effect on sleep structure.

Key words: post-sroke insomnia, transcranial direct current stimulation, anxiety, depression, rehabilitation

CLC Number:

R743.3

GU Bin,HUANG Fubiao,LI Hongyu,SONG Luping. Effect of transcranial direct current stimulation on post-stroke insomnia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(12): 1466-1472.

Figures/Tables 5

References 39

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组别	n	性别(男/女)/n	年龄/岁	病程/月	卒中类型(梗死/出血)/n	病灶侧别(左/右)/n
对照组	20	14/6	58.6±12.58	2.1±1.21	12/8	8/12
试验组	20	14/6	54.2±12.66	2.45±1.43	10/10	7/13
χ²/t值		0.000	0.943	-0.835	0.404	0.107
P值		1.000	0.352	0.409	0.525	0.744

组别	n	治疗前	治疗后	t值	P值
对照组	20	14.65±3.117	11.25±2.511	12.350	< 0.001
试验组	20	14.35±3.200	8.90±2.770	10.903	< 0.001
t值		0.300	2.811
P值		0.766	0.008

组别	n	治疗前	治疗后	t值	P值
对照组	20	18.85±4.452	14.30±2.993	8.828	< 0.001
试验组	20	19.90±5.418	10.85±4.043	9.582	< 0.001
t值		-0.670	3.067
P值		0.507	0.004

组别	n	治疗前	治疗后	t值	P值
对照组	20	21.40±5.355	15.45±3.170	8.575	< 0.001
试验组	20	23.25±6.095	13.40±4.147	9.254	< 0.001
t值		-1.020	1.756
P值		0.314	0.087

睡眠参数	对照组(n = 20)		试验组(n = 20)		t值^a	P值^a	t值^b	P值^b	t值^c	P值^c	t值^d	P值^d
睡眠参数	治疗前	治疗后	治疗前	治疗后	t值^a	P值^a	t值^b	P值^b	t值^c	P值^c	t值^d	P值^d
睡眠质量指数	35.90±9.744	45.35±8.400	36.60±9.875	51.70±9.879	-6.626	< 0.001	-8.983	< 0.001	-0.226	0.823	-2.190	0.035
睡眠总时间/min	289.15±13.768	351.71±10.643	291.39±14.125	388.47±10.838	-89.527	< 0.001	-132.056	< 0.001	-0.507	0.615	-10.824	< 0.001
睡眠潜伏期/min	69.11±15.346	26.13±10.962	71.57±10.064	26.45±4.802	43.840	< 0.001	38.345	< 0.001	-0.601	0.551	-0.121	0.905
睡眠效率/%	57.64±14.15	67.17±14.87	55.44±11.49	78.00±11.79	-59.320	< 0.001	-336.344	< 0.001	0.541	0.592	-2.553	0.015
觉醒转换次数/次	20.95±6.42	18.65±5.78	19.45±5.95	15.00±3.54	4.721	< 0.001	5.784	< 0.001	0.766	0.448	2.409	0.022
快速眼动期/min	8.43±2.41	8.92±5.23	9.15±1.79	10.48±3.88	-0.783	0.443	-2.851	0.010	1.077	0.288	1.073	0.290

Effect of transcranial direct current stimulation on post-stroke insomnia

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