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Changes in spectroscopic biomarkers after transcranial direct current stimulation in children with perinatal stroke.
- Source :
-
Brain stimulation [Brain Stimul] 2018 Jan - Feb; Vol. 11 (1), pp. 94-103. Date of Electronic Publication: 2017 Sep 13. - Publication Year :
- 2018
-
Abstract
- Background: Perinatal stroke causes lifelong motor disability, affecting independence and quality of life. Non-invasive neuromodulation interventions such as transcranial direct current stimulation (tDCS) combined with intensive therapy may improve motor function in adult stroke hemiparesis but is under-explored in children. Measuring cortical metabolites with proton magnetic resonance spectroscopy (MRS) can inform cortical neurobiology in perinatal stroke but how these change with neuromodulation is yet to be explored.<br />Methods: A double-blind, sham-controlled, randomized clinical trial tested whether tDCS could enhance intensive motor learning therapy in hemiparetic children. Ten days of customized, goal-directed therapy was paired with cathodal tDCS over contralesional primary motor cortex (M1, 20 min, 1.0 mA, 0.04 mA/cm <superscript>2</superscript> ) or sham. Motor outcomes were assessed using validated measures. Neuronal metabolites in both M1s were measured before and after intervention using fMRI-guided short-echo 3T MRS.<br />Results: Fifteen children [age(range) = 12.1(6.6-18.3) years] were studied. Motor performance improved in both groups and tDCS was associated with greater goal achievement. After cathodal tDCS, the non-lesioned M1 showed decreases in glutamate/glutamine and creatine while no metabolite changes occurred with sham tDCS. Lesioned M1 metabolite concentrations did not change post-intervention. Baseline function was highly correlated with lesioned M1 metabolite concentrations (N-acetyl-aspartate, choline, creatine, glutamate/glutamine). These correlations consistently increased in strength following intervention. Metabolite changes were not correlated with motor function change. Baseline lesioned M1 creatine and choline levels were associated with clinical response.<br />Conclusions: MRS metabolite levels and changes may reflect mechanisms of tDCS-related M1 plasticity and response biomarkers in hemiparetic children with perinatal stroke undergoing intensive neurorehabilitation.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Aspartic Acid metabolism
Biomarkers
Child
Double-Blind Method
Female
Humans
Male
Motor Cortex metabolism
Paresis complications
Paresis metabolism
Paresis physiopathology
Paresis therapy
Proton Magnetic Resonance Spectroscopy
Stroke complications
Stroke metabolism
Stroke physiopathology
Aspartic Acid analogs & derivatives
Choline metabolism
Creatinine metabolism
Glutamic Acid metabolism
Glutamine metabolism
Motor Cortex physiology
Stroke therapy
Transcranial Direct Current Stimulation
Subjects
Details
- Language :
- English
- ISSN :
- 1876-4754
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Brain stimulation
- Publication Type :
- Academic Journal
- Accession number :
- 28958737
- Full Text :
- https://doi.org/10.1016/j.brs.2017.09.007