Department of Neurology, University of Lübeck, Lübeck, Germany.
Biol Psychiatry. 2011 Oct 1;70(7):690-5. doi: 10.1016/j.biopsych.2011.05.009. Epub 2011 Jun 24.
Controlled transcranial stimulation of the brain is part of clinical treatment strategies in neuropsychiatric diseases such as depression, stroke, or Parkinson's disease. Manipulating brain activity by transcranial stimulation, however, inevitably influences other control centers of various neuronal and neurohormonal feedback loops and therefore may concomitantly affect systemic metabolic regulation. Because hypothalamic adenosine triphosphate-sensitive potassium channels, which function as local energy sensors, are centrally involved in the regulation of glucose homeostasis, we tested whether transcranial direct current stimulation (tDCS) causes an excitation-induced transient neuronal energy depletion and thus influences systemic glucose homeostasis and related neuroendocrine mediators.
In a crossover design testing 15 healthy male volunteers, we increased neuronal excitation by anodal tDCS versus sham and examined cerebral energy consumption with ³¹phosphorus magnetic resonance spectroscopy. Systemic glucose uptake was determined by euglycemic-hyperinsulinemic glucose clamp, and neurohormonal measurements comprised the parameters of the stress systems.
We found that anodic tDCS-induced neuronal excitation causes an energetic depletion, as quantified by ³¹phosphorus magnetic resonance spectroscopy. Moreover, tDCS-induced cerebral energy consumption promotes systemic glucose tolerance in a standardized euglycemic-hyperinsulinemic glucose clamp procedure and reduces neurohormonal stress axes activity.
Our data demonstrate that transcranial brain stimulation not only evokes alterations in local neuronal processes but also clearly influences downstream metabolic systems regulated by the brain. The beneficial effects of tDCS on metabolic features may thus qualify brain stimulation as a promising nonpharmacologic therapy option for drug-induced or comorbid metabolic disturbances in various neuropsychiatric diseases.
大脑的经颅直流电刺激是神经精神疾病（如抑郁症、中风或帕金森病）临床治疗策略的一部分。然而，通过经颅刺激来操纵大脑活动不可避免地会影响到各种神经元和神经激素反馈回路的其他控制中心，因此可能会同时影响全身代谢调节。由于作为局部能量传感器的下丘脑三磷酸腺苷敏感钾通道，在调节葡萄糖稳态中起着核心作用，因此我们测试了经颅直流电刺激（tDCS）是否会引起兴奋诱导的短暂神经元能量耗竭，从而影响全身葡萄糖稳态和相关神经内分泌介质。
在一项交叉设计的测试中，我们对 15 名健康男性志愿者进行了测试，通过阳极 tDCS 与假刺激相比，增加了神经元兴奋，并通过 ³¹磷磁共振波谱检查了大脑的能量消耗。通过正葡萄糖高胰岛素钳夹法测定全身葡萄糖摄取，神经激素测量包括应激系统的参数。
我们发现，阳极 tDCS 诱导的神经元兴奋会导致能量耗竭，这可以通过 ³¹磷磁共振波谱来量化。此外，tDCS 诱导的大脑能量消耗会促进标准化正葡萄糖高胰岛素钳夹过程中的全身葡萄糖耐量，并降低神经激素应激轴的活性。
我们的数据表明，经颅脑刺激不仅会引起局部神经元过程的改变，还会明显影响大脑调节的下游代谢系统。因此，tDCS 对代谢特征的有益影响可能使脑刺激成为各种神经精神疾病中药物诱导或合并代谢紊乱的有前途的非药物治疗选择。
