Adaptation and feasibility of the botulinum toxin therapy with transcranial direct current stimulation for upper limb spasticity of stroke patients

2022 Fiscal Year Final Research Report

• Project/Area Number: 18K10733
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: University of Occupational and Environmental Health, Japan
• Principal Investigator: Saeki Satoru 産業医科大学, 医学部, 教授 (20269070)
• Co-Investigator(Kenkyū-buntansha): 松嶋 康之 産業医科大学, 医学部, 准教授 (10412660) ; 伊藤 英明 産業医科大学, 医学部, 講師 (30609201) ; 白石 純一郎 産業医科大学, 医学部, 非常勤医師 (20525430) ; 蜂須賀 明子 産業医科大学, 医学部, 助教 (90646936)
• Project Period (FY): 2018-04-01 – 2023-03-31
• Keywords: 非侵襲的大脳刺激 / ボツリヌス毒素療法 / 脳卒中 / リハビリテーション

Outline of Final Research Achievements

Botulinum neurotoxin (BoNT) injection is effective for reducing spasticity, but the duration of effectiveness is limited for only 3 months, therefore multiple injections are necessary over the long term. Transcranial direct current stimulation (tDCS) is a potentially novel strategy for reducing post-stroke spasticity, and tDCS might prolong the duration of reducing spasticity by BoNT therapy. The purpose of this study was to examine problems with adaptation and feasibility for the BoNT therapy with anodal tDCS for upper limb spasticity of stroke patients as a preliminary study. A single-blind, randomized sham (placebo)-controlled pretest/posttest study was conducted for stroke patients. This study was completed without the need for stopping per medical monitor. No adverse effects were seen during the intervention. Based on the results of this study, BoNT and tDCS appear to be safe, feasible, and well tolerated in stroke patients.

Free Research Field

リハビリテーション医学

Academic Significance and Societal Importance of the Research Achievements

本研究により、脳卒中片麻痺上肢痙縮に対するボツリヌス療法（BoNTA）と経頭蓋直流電気刺激の効果増強や効果延長などの併用効果がみられる例も確認されたことから、BoNTA追加施注までの期間を延長することが可能となり、対象患者の身体的負担ならびに医療費の軽減が期待される。また、先進的リハビリの発展の一助につながる。