Stroke, as one of the most disabling neurological diseases worldwide, causes significant functional impairments in the lower limbs, severely affecting the quality of life of patients. Traditional neuroregulation techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current/alternating current stimulation (tDCS/tACS) can only intervene in the cerebral cortex. Deep brain stimulation (DBS), which requires invasive craniotomy to implant electrodes and has certain risks, is difficult to fully meet the rehabilitation needs of patients. These treatment methods are insufficient. Transcranial Temporal Interference (TI) Stimulation, as a new non-invasive neuroregulation technology, generates low-frequency envelope signals through high-frequency electric fields to achieve precise stimulation of deep brain tissues, providing a new direction for the treatment of stroke. This study is a clinical research to explore the efficacy of TI technology in the treatment of lower limb dysfunction in stroke, aiming to expand the clinical practice of TI technology in the field of stroke rehabilitation and provide theoretical support and practical guidance for the transformation and application of TI technology.
The patients met the diagnostic criteria of stroke formulated by the Fourth National Cerebrovascular Disease Conference and were confirmed by head CT or MRI.
The duration of the first episode ranged from 1 to 6 months.
Age ranged from 18 to 75 years and both sexes were included.
There was definite lower limb dysfunction, and Brunnstrom stage of lower limbs was II-IV.
People with metallic implants (e.g., aneurysm clips, pacemakers) or skull defects.
Have a history of epilepsy or are taking medications that may lower the seizure threshold.
Patients with severe heart, liver, kidney dysfunction or other serious physical diseases.
Pregnant or lactating women.
Parallel
Transcranial Temporal Interference (TI) Stimulation
DeviceThe stimulation target selected by TI was the contralateral striatum (caudate nucleus), and a head model was constructed based on individualized cranial MRI (T1-weighted image). The 8-12 electrode configuration scheme was optimized using online platforms such as NervioWeb. Stimulation parameters: carrier frequency of 2 kHz and 2.020 kHz, generating a 20 Hz envelope; initial current intensity of 2 mA per electrode, gradually increasing to the tolerated upper limit (single electrode ≤ 5 mA, total current ≤ 10 mA); 20 minutes each time, 5 times a week, for a total of 3 weeks.
routine rehabilitation
Other interventionThe routine rehabilitation strictly follows the standard treatment protocols recommended by domestic and international guidelines such as "Chinese Guidelines for Stroke Rehabilitation Therapy", including secondary prevention with medication, task-oriented lower limb muscle strength training, balance training, gait correction training, and physical factor therapy. This is carried out by rehabilitation therapists according to the hospital's routine procedures, 5 times a week, each session lasting approximately 60 minutes, for a total of 3 weeks.
TI sham stimulation
DeviceThe electrode application, positioning, and equipment operation procedures are exactly the same as those in the true stimulation group. The current gradually increases from a 30-second ramp to the preset intensity and then immediately returns to zero. Only the first 30 seconds cause a slight sensation on the scalp, and no effective modulated electric field is generated thereafter. 20 minutes each time, 5 times a week, for a total of 3 weeks.
Lower extremity part of Fugl-Meyer rating scale
The Fugl-Meyer Assessment Lower Extremity component (FMA-LE) is a standardized tool for the assessment of lower limb motor function in patients after stroke. It contains 17 items and is divided into two subscales: lower limb motor and coordination/speed . Higher scores indicate better function. For each item, a score of 0 indicates unable to complete/no function, a score of 1 indicates partially completed/partially functional, and a score of 2 indicates fully completed/normal function.
Holden Functional grading assessment scale for walking
Holden functional classification of walking scale is a classic observational scale to assess the walking independence of patients
Berg Balance Scale
For the balance function of the lower limbs, the Berg balance Scale was used. The scale contains 14 items covering tasks of varying difficulty ranging from balance in a sitting position to standing on one leg. Each item was scored on a 5-point scale from 0 to 4, with a total score ranging from 0 to 56. Higher scores indicate better balance.
Modified Barthel Index
The Modified Barthel Index (MBI) was used to evaluate the activities of daily living of patients
Motor evoked potential
TMS was used to detect the latency and amplitude of MEP of tibial anterior muscle and quadriceps femoris muscle on the affected and healthy sides, and to evaluate the cortical excitability of M1 area and the conduction function (conduction velocity and integrity) of corticospinal tract.
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The Third People's Hospital of Huizhou
Lead sponsor
Guangdong Pharmaceutical University
Collaborator
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