La “Stimolazione transcranica Random Noise” (tRNS) e la riabilitazione motoria dell’arto superiore nel paziente in fase subacuta di ictus ischemico.

"RANDOM NOISE TRANSCRANIAL STIMULATION" (TRNS) AND MOTOR REHABILITATION OF THE UPPER LIMB IN SUBACUTE ISCHEMIC STROKE PATIENTS. BACKGROUND Upper limb impairment is a common outcome after stroke. New rehabilitative interventions partially failed to show a superior effect compared to standard therapy. The present study focuses on the effect of tNRS in the sub-acute stage after stroke. The primary aim is to evaluate the combined use of TRNS with the GRASP in subacute ischemic stroke patients. METHODS A double-blind RCT, approved by local committee, was performed. Patients with upper-limb impairment were recruited 1 to 6 weeks after stroke. Participants were randomly allocated to two groups: GRASP+tRNS and GRASP+Sham stimulation. Each patient underwent 5 session (1 session/day). Fugl-Meyer Assessment Upper extremity (FMA-UE) was performed to evaluate upper limb impairment before treatment (T0) at the end (T1) and after a month (T2). Clinical and demographic characteristics and changes between baseline data and follow-up were compared between groups with the t tests and the chi-square test for the continuous and categorical variables. Anova was used to evaluate the differences among groups( level of significance of 95% (p <0.05). RESULTS 11 men and 13 women were recruited, (age range from 55 to 92 years). FMA-UE, (T0), (T1) and (T2) average scores were 43,08, 48,46 and 60,62 respectively (42,42; 48,17 ; 56,18 for TRNs and 43,75; 48,75 and 53,58 for sham). TRNS group reported a significant improvement in FMA-UE score after treatment. CONCLUSIONS The additional use of tRNS to GRASP seems to have a significant beneficial effect . These results should be verified by additional confirmatory studies.