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Título

LESION MAPPING IN PATIENTS WITH STROKE SUBMITTED TO TRANSCRANIAL DIRECT CURRENT STIMULATION FOR UNILATERAL SPATIAL NEGLECT

Resumo

Introduction: Transcranial direct current stimulation (tDCS) may be useful in the management of patients with stroke and unilateral spatial neglect. In a previous investigation we described a better recovery of patients submitted to anodal tDCS.

Objective: Use neuroimaging to access structural predictors of the outcomes those patients submitted to tDCS.

Methods: Patients with stroke and unilateral spatial neglect were randomized in 3 groups (anodal tDCS [group 1] cathodal tDCS [group 2] and control [group 3]). High resolution computerized tomography scans in the sub-acute phase of the stroke were obtained. Lesions were semi-automatically segmented and normalized. Extension of the lesions based of regions of interest (ROIs) were extracted using the Atlas of Anatomical Labeling. Only gray matter of right hemisphere was evaluated, and the total area analyzed was 642.745mm3. Statistical analysis was conducted using chi-square test.

Results: For group 1 (n=8, mean age 66 years), extension of damage obtained was 194.241mm3 (30% of all ROIs) centered in the amygdala; for group 2 (n=8, mean age 61), 79.100mm3 (12% of all ROIs) centered in the amygdala and for group 3 (n=7, mean age 68) 49.789mm3 (8% of all ROIs) centered in the insula. Group 1 was statistically different when compared to group 2 and 3 (p=0.001 and p<0.001). There was no difference between group 2 and 3 (p=0.9).

Conclusion: A larger area of damage was observed in patients with stroke submitted to anodal tDCS. Despite the increased area of damage compared to the other groups these individuals presented a better outcome indicating that this approach may be useful in these patients.