Priori Alberto, Ciocca Matteo, Parazzini Marta, Vergari Maurizio, Ferrucci Roberta
Centro Clinico per la Neurostimolazione, le Neurotecnologie e i Disordini del Movimento, Fondazione IRCCS Ca' Granda, Milan, Italy Dipartimento di Fisiopatologia Medico Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
Centro Clinico per la Neurostimolazione, le Neurotecnologie e i Disordini del Movimento, Fondazione IRCCS Ca' Granda, Milan, Italy Dipartimento di Fisiopatologia Medico Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy.
J Physiol. 2014 Aug 15;592(16):3345-69. doi: 10.1113/jphysiol.2013.270280. Epub 2014 Jun 6.
Two neuromodulatory techniques based on applying direct current (DC) non-invasively through the skin, transcranial cerebellar direct current stimulation (tDCS) and transcutaneous spinal DCS, can induce prolonged functional changes consistent with a direct influence on the human cerebellum and spinal cord. In this article we review the major experimental works on cerebellar tDCS and on spinal tDCS, and their preliminary clinical applications. Cerebellar tDCS modulates cerebellar motor cortical inhibition, gait adaptation, motor behaviour, and cognition (learning, language, memory, attention). Spinal tDCS influences the ascending and descending spinal pathways, and spinal reflex excitability. In the anaesthetised mouse, DC stimulation applied under the skin along the entire spinal cord may affect GABAergic and glutamatergic systems. Preliminary clinical studies in patients with cerebellar disorders, and in animals and patients with spinal cord injuries, have reported beneficial effects. Overall the available data show that cerebellar tDCS and spinal tDCS are two novel approaches for inducing prolonged functional changes and neuroplasticity in the human cerebellum and spinal cord, and both are new tools for experimental and clinical neuroscientists.
两种基于经皮肤无创施加直流电（DC）的神经调节技术，即经颅小脑直流电刺激（tDCS）和经皮脊髓直流电刺激，可以诱导与对人类小脑和脊髓的直接影响相一致的长期功能变化。在本文中，我们综述了关于小脑tDCS和脊髓tDCS的主要实验研究及其初步临床应用。小脑tDCS可调节小脑运动皮质抑制、步态适应性、运动行为和认知（学习、语言、记忆、注意力）。脊髓tDCS影响脊髓的上行和下行通路以及脊髓反射兴奋性。在麻醉的小鼠中，沿整个脊髓在皮肤下施加直流电刺激可能会影响γ-氨基丁酸能（GABAergic）和谷氨酸能系统。对小脑疾病患者以及脊髓损伤的动物和患者进行的初步临床研究报告了有益效果。总体而言，现有数据表明，小脑tDCS和脊髓tDCS是在人类小脑和脊髓中诱导长期功能变化和神经可塑性的两种新方法，并且两者都是实验和临床神经科学家的新工具。
