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塑造经颅直流电刺激人类运动皮层的效果。

Shaping the effects of transcranial direct current stimulation of the human motor cortex.

作者信息

Nitsche M A, Doemkes S, Karaköse T, Antal A, Liebetanz D, Lang N, Tergau F, Paulus W

机构信息

Department for Clinical Neurophysiology, Georg-August-University, Goettingen, Germany.

出版信息

J Neurophysiol. 2007 Apr;97(4):3109-17. doi: 10.1152/jn.01312.2006. Epub 2007 Jan 24.

Abstract

Transcranial DC stimulation (tDCS) induces stimulation polarity-dependent neuroplastic excitability shifts in the human brain. Because it accomplishes long-lasting effects and its application is simple, it is used increasingly. However, one drawback is its low focality, caused by 1) the large stimulation electrode and 2) the functionally effective reference electrode, which is also situated on the scalp. We aimed to increase the focality of tDCS, which might improve the interpretation of the functional effects of stimulation because it will restrict its effects to more clearly defined cortical areas. Moreover, it will avoid unwanted reversed effects of tDCS under the reference electrode, which is of special importance in clinical settings, when a homogeneous shift of cortical excitability is needed. Because current density (current strength/electrode size) determines the efficacy of tDCS, increased focality should be accomplished by 1) reducing stimulation electrode size, but keeping current density constant; or 2) increasing reference electrode size under constant current strength. We tested these hypotheses for motor cortex tDCS. The results show that reducing the size of the motor cortex DC-stimulation electrode focalized the respective tDCS-induced excitability changes. Increasing the size of the frontopolar reference electrode rendered stimulation over this cortex functionally inefficient, but did not compromise the tDCS-generated motor cortical excitability shifts. Thus tDCS-generated modulations of cortical excitability can be focused by reducing the size of the stimulation electrode and by increasing the size of the reference electrode. For future applications of tDCS, such paradigms may help to achieve more selective tDCS effects.

摘要

经颅直流电刺激(tDCS)可在人脑中诱导出刺激极性依赖性的神经可塑性兴奋性变化。由于它能产生持久的效果且应用简单,其使用越来越广泛。然而,它存在一个缺点,即聚焦性低,这是由以下两个原因导致的:1)刺激电极较大;2)功能有效的参考电极也位于头皮上。我们旨在提高tDCS的聚焦性,这可能会改善对刺激功能效果的解读,因为这样能将其效果限制在更明确界定的皮质区域。此外,它还能避免在参考电极下方出现tDCS不必要的反向效应,这在临床环境中尤为重要,因为此时需要皮质兴奋性的均匀变化。由于电流密度(电流强度/电极大小)决定了tDCS的效果,提高聚焦性应通过以下两种方式实现:1)减小刺激电极大小,但保持电流密度不变;或2)在恒定电流强度下增大参考电极大小。我们针对运动皮质tDCS对这些假设进行了测试。结果表明,减小运动皮质直流电刺激电极的大小可使相应的tDCS诱导的兴奋性变化更聚焦。增大额极参考电极的大小会使该皮质上的刺激在功能上效率低下,但不会影响tDCS产生的运动皮质兴奋性变化。因此,通过减小刺激电极大小和增大参考电极大小,可以使tDCS产生的皮质兴奋性调制更聚焦。对于tDCS的未来应用,此类范式可能有助于实现更具选择性的tDCS效果。

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