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采用经颅直流电刺激和物理训练改善脑白质疏松症患者的步态和平衡:一项探索性研究。

Improving gait and balance in patients with leukoaraiosis using transcranial direct current stimulation and physical training: an exploratory study.

机构信息

1Imperial College London, Charing Cross Hospital, London, UK.

出版信息

Neurorehabil Neural Repair. 2013 Nov-Dec;27(9):864-71. doi: 10.1177/1545968313496328. Epub 2013 Jul 29.

Abstract

BACKGROUND

Leukoaraiosis describes ischemic white matter lesions, a leading cause of gait disturbance in the elderly.

OBJECTIVE

Our aim was to improve gait and balance in patients with leukoaraiosis by combining a single session of transcranial direct current stimulation (tDCS) and physical training (PT).

METHODS

We delivered anodal tDCS over midline motor and premotor areas in 9 patients with leukoaraiosis. Patients underwent gait and balance training during tDCS stimulation (real/sham). This was repeated 1 week later with the stimulation crossed-over (sham/real) in a double-blind design. Assessments included gait velocity, stride length, stride length variability (primary gait outcomes), and a quantitative retropulsion test (primary balance outcome).

RESULTS

. Combining tDCS and PT improved gait velocity, stride length, stride length variability, and balance (all at P ≤ .05). Overall, training without tDCS showed no significant effects.

CONCLUSIONS

Combined anodal tDCS and PT improves gait and balance in this patient group, suggesting that tDCS could be an effective adjunct to PT in patients with leukoaraiosis, for whom no treatment is currently available.

摘要

背景

脑白质疏松症描述了缺血性的脑白质病变,这是老年人步态障碍的主要原因。

目的

我们旨在通过经颅直流电刺激(tDCS)和物理训练(PT)联合单次治疗来改善脑白质疏松症患者的步态和平衡。

方法

我们对 9 名脑白质疏松症患者的中线运动区和运动前区进行了阳极 tDCS 治疗。在 tDCS 刺激(真实/假刺激)期间,患者接受了步态和平衡训练。在双盲设计中,一周后将刺激交叉(假刺激/真刺激)重复进行。评估包括步态速度、步长、步长变异性(主要步态结果)和定量后退测试(主要平衡结果)。

结果

tDCS 联合 PT 改善了步态速度、步长、步长变异性和平衡(均 P≤0.05)。总的来说,没有 tDCS 的训练没有显著效果。

结论

阳极 tDCS 联合 PT 改善了该患者群体的步态和平衡,这表明 tDCS 可能是脑白质疏松症患者 PT 的有效辅助治疗方法,因为目前尚无针对这种疾病的治疗方法。

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