Research on electroencephalogram power spectral density of stroke patients under transcranial direct current stimulation_Journal of Biomedical Engineering

Authors：

LIU Mengmeng ^1,2 ,  XU Guizhi ^1,2 ,  YU Hongli ^1,2 , WANG Chunfang ³ , SUN Changcheng ³ , GUO Lei ^1,2

1. State Key Laboratory of Reliability and Intelligence of Electrical Equipment, School of Electrical Engineering, Hebei University of Technology, Tianjin 300130, P. R. China;
2. Tianjin Key Laboratory of Bioelectromagnetic Technology and Intelligent Health, Hebei University of Technology, Tianjin 300130, P. R. China;
3. Rehabilitation Medical Department, Tianjin Union Medical Center, Tianjin 300121, P. R. China;

Corresponding author：

XU Guizhi, Email: gzxu@hebut.edu.cn; YU Hongli, Email: yhlzyn@hebut.edu.cn

Keywords：

transcranial direct current stimulation; stroke; electroencephalogram; power spectral density

DOI：

10.7507/1001-5515.202110081

Video：

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Transcranial direct current stimulation (tDCS) has become a new method of post-stroke rehabilitation treatment and is gradually accepted by people. However, the neurophysiological mechanism of tDCS in the treatment of stroke still needs further study. In this study, we recruited 30 stroke patients with damage to the left side of the brain and randomly divided them into a real tDCS group (15 cases) and a sham tDCS group (15 cases). The resting EEG signals of the two groups of subjects before and after stimulation were collected, then the difference of power spectral density was analyzed and compared in the band of delta, theta, alpha and beta, and the delta/alpha power ratio (DAR) was calculated. The results showed that after real tDCS, delta band energy decreased significantly in the left temporal lobes, and the difference was statistically significant (P < 0.05); alpha band energy enhanced significantly in the occipital lobes, and the difference was statistically significant (P < 0.05); the difference of theta and beta band energy was not statistically significant in the whole brain region (P > 0.05). Furthermore, the difference of delta, theta, alpha and beta band energy was not statistically significant after sham tDCS (P > 0.05). On the other hand, the DAR value of stroke patients decreased significantly after real tDCS, and the difference was statistically significant (P < 0.05), and there was no significant difference in sham tDCS (P > 0.05). This study reveals to a certain extent the neurophysiological mechanism of tDCS in the treatment of stroke.

Citation： LIU Mengmeng, XU Guizhi, YU Hongli, WANG Chunfang, SUN Changcheng, GUO Lei. Research on electroencephalogram power spectral density of stroke patients under transcranial direct current stimulation. Journal of Biomedical Engineering, 2022, 39(3): 498-506. doi: 10.7507/1001-5515.202110081 Copy

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2.	Spence J D. China stroke statistics 2019: a wealth of opportunities for stroke prevention. Stroke Vasc Neurol, 2020, 5(3): 240-241.
3.	Hatem S M, Geoffroy S, Margaux D F, et al. Rehabilitation of motor function after stroke: a multiple systematic review focused on techniques to stimulate upper extremity recovery. Front Hum Neurosci, 2016, 10: 442.
4.	Schlaug G, Renga V. Transcranial direct current stimulation: a noninvasive tool to facilitate stroke recovery. Expert Rev Med Devices, 2008, 5(6): 759-768.
5.	Nowak D, Bösl K, Podubeckà J, et al. Noninvasive brain stimulation and motor recovery after stroke. Restor Neurol Neurosci, 2010, 28(4): 531-544.
6.	Elsner B, Kwakkel G, Kugler J, et al. Transcranial direct current stimulation (tDCS) for improving capacity in activities and arm function after stroke: a network meta-analysis of randomised controlled trials. J Neuroeng Rehabil, 2017, 14(1): 95.
7.	Brunoni A R, Nitsche M A, Bolognini N, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimul, 2012, 5(3): 175-195.
8.	王伟, 宋为群, 张艳明, 等. 经颅直流电刺激对脑卒中患者上肢运动功能康复的效果. 中国康复理论与实践, 2021, 27(9): 1082-1086.
9.	Bolognini N, Russo C, Souza C M, et al. Bi-hemispheric transcranial direct current stimulation for upper-limb hemiparesis in acute stroke: a randomized, double-blind, sham-controlled trial. Eur J Neurol, 2020, 27(12): 2473-2482.
10.	Purdon P L, Sampson A, Pavone K J, et al. Clinical electroencephalography for anesthesiologists: part I: background and basic signatures. Anesthesiology, 2015, 123(4): 937-960.
11.	覃小雅, 袁媛, 陈彦, 等. 头皮脑电图在迷走神经电刺激治疗难治性癫痫研究中的应用. 生物医学工程学杂志, 2020, 37(4): 699-707.
12.	Saes M, Meskers C, Daffertshofer A, et al. How does upper extremity Fugl-Meyer motor score relate to resting-state EEG in chronic stroke? A power spectral density analysis. Clinical Neurophysiology, 2019, 130(5): 856-862.
13.	Finnigan S, Wong A, Read S. Defining abnormal slow EEG activity in acute ischaemic stroke: delta/alpha ratio as an optimal QEEG index. Clinical Neurophysiology, 2016, 127(2): 1452-1459.
14.	Jin M, Zhang Z, Bai Z, et al. Timing-dependent interaction effects of tDCS with Mirror therapy on upper extremity motor recovery in patients with chronic stroke: a randomized controlled pilot study. J Neurol Sci, 2019: 116436.
15.	Ochi M, Saeki S, Oda T, et al. Effects of anodal and cathodal transcranial direct current stimulation combined with robotic therapy on severely affected arms in chronic stroke patients. J Rehabil Med, 2013, 45(2): 137-140.
16.	Suntrup-Krueger S, Ringmaier C, Muhle P, et al. Randomized trial of transcranial DC stimulation for post-stroke dysphagia. Ann Neurol, 2018, 83(2): 328-340.
17.	Klomjai W, Aneksan B, Pheungphrarattanatrai A, et al. Effect of single-session dual-tDCS before physical therapy on lower-limb performance in sub-acute stroke patients: a randomized sham-controlled crossover study. Ann Phys Rehabil Med, 2018, 61(5): 286-291.
18.	Delorme A, Makeig S. EEGLAB: an open source toolbox for analysis of single-trial EEG dynamics including independent component analysis. J Neurosci Methods, 2004, 134(1): 9-21.
19.	Saes M, Zandvliet S B, Andringa A S, et al. Is Resting-State EEG longitudinally associated with recovery of clinical neurological impairments early poststroke? a prospective cohort study. Neurorehabil Neural Repair, 2020, 34(5): 389-402.
20.	Babiloni C, Barry R, Basar E, et al. International federation of clinical neurophysiology(IFCN)-EEG research workgroup: recommendations on frequency and topographic analysis of resting state EEG rhythms. Part 1: applications in clinical research studies. Clinical Neurophysiology, 2020, 131(1): 285-307.
21.	Min Y S, Park J W, Jang K, et al. Power spectral density analysis of long-term motor recovery in patients with subacute stroke. Neurorehabil Neural Repair, 2019, 33(1): 38-46.
22.	程振仕. 基于EEG的脑卒中评估方法研究及病灶定位. 秦皇岛: 燕山大学, 2019.
23.	Classen J, Schnitzler A, Binkofski F, et al. The motor syndrome associated with exaggerated inhibition within the primary motor cortex of patients with hemiparetic. Brain, 1997, 120 ( Pt 4)(4): 605-619.
24.	Woods A J, Antal A, Bikson M, et al. A technical guide to tDCS, and related non-invasive brain stimulation tools. Clinical Neurophysiology, 2016, 127(2): 1031-1048.
25.	Fregni F, Freedman S, Pascual-Leone A. Recent advances in the treatment of chronic pain with non-invasive brain stimulation techniques. Lancet Neurol, 2007, 6(2): 188-191.
26.	Filmer H L, Dux P E, Mattingley J B. Applications of transcranial direct current stimulation for understanding brain function. Trends Neurosci, 2014, 37(12): 742-753.
27.	Nitsche M A, Cohen L G, Wassermann E M, et al. Transcranial direct current stimulation: state of the art 2008. Brain Stimul, 2008, 1(3): 206-223.
28.	Finnigan S P, Walsh M, Rose S E, et al. Quantitative EEG indices of sub-acute ischaemic stroke correlate with clinical outcomes. Clinical Neurophysiology, 2007, 118(11): 2525-2532.

1. Krishnamurthi R V, Moran A E, Feigin V L, et al, Stroke prevalence, mortality and disability-adjusted Life years in adults aged 20-64 years in 1990-2013: data from the global burden of disease 2013 study. Neuroepidemiology, 2015, 45(3): 190-202.
2. Spence J D. China stroke statistics 2019: a wealth of opportunities for stroke prevention. Stroke Vasc Neurol, 2020, 5(3): 240-241.
3. Hatem S M, Geoffroy S, Margaux D F, et al. Rehabilitation of motor function after stroke: a multiple systematic review focused on techniques to stimulate upper extremity recovery. Front Hum Neurosci, 2016, 10: 442.
4. Schlaug G, Renga V. Transcranial direct current stimulation: a noninvasive tool to facilitate stroke recovery. Expert Rev Med Devices, 2008, 5(6): 759-768.
5. Nowak D, Bösl K, Podubeckà J, et al. Noninvasive brain stimulation and motor recovery after stroke. Restor Neurol Neurosci, 2010, 28(4): 531-544.
6. Elsner B, Kwakkel G, Kugler J, et al. Transcranial direct current stimulation (tDCS) for improving capacity in activities and arm function after stroke: a network meta-analysis of randomised controlled trials. J Neuroeng Rehabil, 2017, 14(1): 95.
7. Brunoni A R, Nitsche M A, Bolognini N, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimul, 2012, 5(3): 175-195.
8. 王伟, 宋为群, 张艳明, 等. 经颅直流电刺激对脑卒中患者上肢运动功能康复的效果. 中国康复理论与实践, 2021, 27(9): 1082-1086.
9. Bolognini N, Russo C, Souza C M, et al. Bi-hemispheric transcranial direct current stimulation for upper-limb hemiparesis in acute stroke: a randomized, double-blind, sham-controlled trial. Eur J Neurol, 2020, 27(12): 2473-2482.
10. Purdon P L, Sampson A, Pavone K J, et al. Clinical electroencephalography for anesthesiologists: part I: background and basic signatures. Anesthesiology, 2015, 123(4): 937-960.
11. 覃小雅, 袁媛, 陈彦, 等. 头皮脑电图在迷走神经电刺激治疗难治性癫痫研究中的应用. 生物医学工程学杂志, 2020, 37(4): 699-707.
12. Saes M, Meskers C, Daffertshofer A, et al. How does upper extremity Fugl-Meyer motor score relate to resting-state EEG in chronic stroke? A power spectral density analysis. Clinical Neurophysiology, 2019, 130(5): 856-862.
13. Finnigan S, Wong A, Read S. Defining abnormal slow EEG activity in acute ischaemic stroke: delta/alpha ratio as an optimal QEEG index. Clinical Neurophysiology, 2016, 127(2): 1452-1459.
14. Jin M, Zhang Z, Bai Z, et al. Timing-dependent interaction effects of tDCS with Mirror therapy on upper extremity motor recovery in patients with chronic stroke: a randomized controlled pilot study. J Neurol Sci, 2019: 116436.
15. Ochi M, Saeki S, Oda T, et al. Effects of anodal and cathodal transcranial direct current stimulation combined with robotic therapy on severely affected arms in chronic stroke patients. J Rehabil Med, 2013, 45(2): 137-140.
16. Suntrup-Krueger S, Ringmaier C, Muhle P, et al. Randomized trial of transcranial DC stimulation for post-stroke dysphagia. Ann Neurol, 2018, 83(2): 328-340.
17. Klomjai W, Aneksan B, Pheungphrarattanatrai A, et al. Effect of single-session dual-tDCS before physical therapy on lower-limb performance in sub-acute stroke patients: a randomized sham-controlled crossover study. Ann Phys Rehabil Med, 2018, 61(5): 286-291.
18. Delorme A, Makeig S. EEGLAB: an open source toolbox for analysis of single-trial EEG dynamics including independent component analysis. J Neurosci Methods, 2004, 134(1): 9-21.
19. Saes M, Zandvliet S B, Andringa A S, et al. Is Resting-State EEG longitudinally associated with recovery of clinical neurological impairments early poststroke? a prospective cohort study. Neurorehabil Neural Repair, 2020, 34(5): 389-402.
20. Babiloni C, Barry R, Basar E, et al. International federation of clinical neurophysiology(IFCN)-EEG research workgroup: recommendations on frequency and topographic analysis of resting state EEG rhythms. Part 1: applications in clinical research studies. Clinical Neurophysiology, 2020, 131(1): 285-307.
21. Min Y S, Park J W, Jang K, et al. Power spectral density analysis of long-term motor recovery in patients with subacute stroke. Neurorehabil Neural Repair, 2019, 33(1): 38-46.
22. 程振仕. 基于EEG的脑卒中评估方法研究及病灶定位. 秦皇岛: 燕山大学, 2019.
23. Classen J, Schnitzler A, Binkofski F, et al. The motor syndrome associated with exaggerated inhibition within the primary motor cortex of patients with hemiparetic. Brain, 1997, 120 ( Pt 4)(4): 605-619.
24. Woods A J, Antal A, Bikson M, et al. A technical guide to tDCS, and related non-invasive brain stimulation tools. Clinical Neurophysiology, 2016, 127(2): 1031-1048.
25. Fregni F, Freedman S, Pascual-Leone A. Recent advances in the treatment of chronic pain with non-invasive brain stimulation techniques. Lancet Neurol, 2007, 6(2): 188-191.
26. Filmer H L, Dux P E, Mattingley J B. Applications of transcranial direct current stimulation for understanding brain function. Trends Neurosci, 2014, 37(12): 742-753.
27. Nitsche M A, Cohen L G, Wassermann E M, et al. Transcranial direct current stimulation: state of the art 2008. Brain Stimul, 2008, 1(3): 206-223.
28. Finnigan S P, Walsh M, Rose S E, et al. Quantitative EEG indices of sub-acute ischaemic stroke correlate with clinical outcomes. Clinical Neurophysiology, 2007, 118(11): 2525-2532.

Journal of Biomedical Engineering

Research on electroencephalogram power spectral density of stroke patients under transcranial direct current stimulation

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