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Vol. 19, Art. 37 (pp. 496-517)    |    2018       

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Translingual neurostimulation in late residual stage cerebral palsy children treatment affects functional brain networks

Efimtsev A.Y.1, Ignatova T.S.2, Scoromets A.P. Trufanov A.G.3, Levchuk A.G.1, Trufanov G.E.1, Kondratyeva E.N.1, Shmedyk N.Y.1, Vladislav G. Volkov 2,7, Linda Kalinina 2,5 ,Sarana A.M.2,5, Shcherbak S.G.2,5, Danilov Y.P.4
1 The Almazov National Medical Research Centre, St. Petersburg, Russian Federation
2St. Petersburg State Healthcare Institution City Hospital No. 40, 197706, St. Petersburg,Borisova str., 9
3Military Medical Academy n.a. S.M.Kirov, St. Petersburg, Akademika Lebedeva str., 6
4Institute of Physiology n.a. I.P. Pavlov, Russian Academy of Sciences, St. Petersburg, Russia, Makarova Embankment, 6
5St. Petersburg University, St. Petersburg, Russia, University Embankment 7-9
6 Children's City Hospital N1 Department of Neonatology and Neonatal Resuscitation
7Federal State Budgetary Educational Institution of Higher Education
First St. Petersburg State Medical University named after academician I.P. Pavlova of the Ministry of Health of the Russian Federation, St. Petersburg, ul. Lev Tolstoy, 6-8, index 197022

Brief summary

Management of cerebral palsy is an actual problem of modern medicine. A new direction of neurorehabilitation, intensively discussed in modern science and practice, includes various types of electrical stimulation. Constant stimulation of the nervous system is one of the most popular ways to activate neural networks to activate the brain and initiate neuroplasticity processes. Purpose: to complete the first controlled study of the translingual neurostimulation ability to facilitate existing methods of physical rehabilitation at children with a cerebral palsy and to evaluate the safety of the method, duration, and sustainability of effects. Methods: Translingual neurostimulation is a new noninvasive method in neurorehabilitation. It permits to activate multiple structures of the brain that are deeply involved in mechanisms of sensory-motor integration. The study of translingual neurostimulation effects on balance, coordination of the movement, formation of motor skills was completed at the state hospital, GB N40, Sestroretsk. The study includes 134 patients with the expressed coordination and mobility symptoms, aged from 2 up to 17 years and with the proved diagnosis "Cerebral palsy, spastic diplegia". The control group (40 people) received standard treatment (massage, remedial gymnastics, use of exercise machines, robotic mechanotherapy, and balneotherapy). The primary, active group (94 people) received standard treatment and additional translingual neurostimulation. All children were assessed before and after a course of therapy using standard scales for spasticity, balance and motor skills (Ashworth's scale, Berg's scale, FMS scale). The part of subjects in both testing groups repeat the therapy two or more times. The break between courses was between 6 and 12 months. All subjects underwent standard treatment, including massage, therapeutic gymnastics simulators, robotic mechanotherapy, etc., which lasted 20-25 minutes with neurostimulation of the brain. All subjects underwent a resting state functional MRI once before and twice - after neurostimulation course. Results indicate positive dynamics in all subjects: most of them learned walking without aids, obtained decreased muscle tonus and improvement in balance, coordination function were noted. Neurostimulation in combined with curative gymnastics (focused exercises), improves the efficiency of motor functions and the development of motor skills. Resting state functional MRI showed improvement in brain networks. If performed properly, it can be an auxiliary method of objective control of treatment effectiveness.


Key words

Neuro-electrostimulation, Neuroimaging, Functional MRI, cerebral palsy, neuroplasticity.

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