INFLUENCE OF TRANSCRANIAL MICROPOLARISATION ON BRAIN HEMODYNAMICS IN PATIENTS WITH PERINATAL HYPOXIC-ISCHEMIC ENCEPHALOPATHY

Abstract

Introduction. Perinatal hypoxic-ischemic encephalopathy (HIE) is a major issue of neurology and neonatology. A promising non-invasive tool for modeling the activity of the brain – transcranial direct current stimulation – is of particular interest in the treatment of HIE.

The aim of the study was to investigate the possibility of using direct current stimulation in combined treatment of patients with perinatal hypoxic-ischemic encephalopathy.

Material and Methods. 45 children aged 2 to 12 years with hypoxic-ischemic encephalopathy were examined and treated at the "Neurological Clinic of Dr. Yatsenko" (Kyiv). The comparison group was formed from 15 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 transcranial direct current stimulation (tDCS). tDCS was performed according to the individual treatment regimens. A transcranial Doppler ultrasound examination of head blood vessels was used for the study of cerebral hemodynamics in children with HIE before and after combined treatment with tDCS.

Results. tDCS reduced asymmetry coefficient of blood flow velocity in the middle cerebral arteries (MCA) by 12.7 %, whereas in the comparison group only by 4.4 %; in the anterior cerebral arteries (ACA) – by 9.5 %, while in the comparison group – 1.1 %. tDCS significantly reduced the high mean blood flow velocity per cycle (MFV) in the basilar artery (BA), MCA and ACA (by 22.0 %, 17.7 % and 7.5 % respectively); in the comparison group no statistically significant positive dynamics was observed. tDCS significantly increased the low MVF in the BA, MCA and ACA (by 28.4 %, 21.9 % and 10.4 % respectively); a statistically significant increase of MVF by 10.1 % was only in the CMA in the comparison group of patients.

Conclusions. The obtained results showed that combined therapy with transcranial direct current stimulation improved the cerebral hemodynamics parameters in patients with HIE and also positively influenced the clinical course of the disease.