The effect of combined treatment with transcranial direct current stimulation on cerebral blood flow in patients with cerebral palsy

Abstract

There is a close link between the activity of the brain and cerebral blood supply. Transcranial direct current stimulation (tDCS) modulates the activity of the cerebral cortex and thus affects the cerebral blood flow. The aim of the study was to investigate the effect of combined treatment with tDCS on cerebral blood flow in patients with cerebral palsy (CP). Materials and Methods. 60 patients with various forms of cerebral palsy were examined and received the course of treatment. The comparison group was formed from 30 children who received the course of basic medical and rehabilitation procedures. The main group included 30 children who, in addition to the same therapy, received a course of tDCS. A transcranial Doppler ultrasound examination of head blood vessels was used for the study of cerebral hemodynamics in children with cerebral palsy before and after combined treatment with tDCS. Results. tDCS reduced asymmetry coefficient of blood flow velocity in the middle cerebral arteries (MCA) by 12.3 %, whereas in the comparison group only by 2.5 %; in the anterior cerebral artery (ACA) – 9.5 %, while in the comparison group – 0.8 %. tDCS significantly reduced the high mean blood flow velocity per cycle (MFV) in the basilar artery (BA), MCA and ACA (21.7 %, 18.3 % and 7.8 %, respectively); in the comparison group no statistically significant positive dynamics was observed. tDCS significantly increased the low MVF in the BA, MCA and ACA (29.7 %, 21.2 % and 9.7 % respectively); a statistically significant increase of MVF by 9.9 % was only in the CMA in the comparison group of patients. Conclusions. Our data indicate that the use of tDCS in the combined treatment of CP patients improves cerebral hemodynamics in 87 % of patients, in contrast to 52 % in the comparison group. The addition of transcranial direct current stimulation method to the complex treatment of patients with cerebral palsy improves the effectiveness of treatment and may also positively influence on the disease clinical course.