Department of Physiotherapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia.
Eur J Neurosci. 2017 Aug;46(4):1968-1990. doi: 10.1111/ejn.13640. Epub 2017 Aug 2.
Numerous studies have explored the effects of transcranial electrical stimulation (tES) - including anodal transcranial direct current stimulation (a-tDCS), cathodal transcranial direct current stimulation (c-tDCS), transcranial alternative current stimulation (tACS), transcranial random noise stimulation (tRNS) and transcranial pulsed current stimulation (tPCS) - on corticospinal excitability (CSE) in healthy populations. However, the efficacy of these techniques and their optimal parameters for producing robust results has not been studied. Thus, the aim of this systematic review was to consolidate current knowledge about the effects of various parameters of a-tDCS, c-tDCS, tACS, tRNS and tPCS on the CSE of the primary motor cortex (M1) in healthy people. Leading electronic databases were searched for relevant studies published between January 1990 and February 2017; 126 articles were identified, and their results were extracted and analysed using RevMan software. The meta-analysis showed that a-tDCS application on the dominant side significantly increases CSE (P < 0.01) and that the efficacy of a-tDCS is dependent on current density and duration of application. Similar results were obtained for stimulation of M1 on the non-dominant side (P = 0.003). The effects of a-tDCS reduce significantly after 24 h (P = 0.006). Meta-analysis also revealed significant reduction in CSE following c-tDCS (P < 0.001) and significant increases after tRNS (P = 0.03) and tPCS (P = 0.01). However, tACS effects on CSE were only significant when the stimulation frequency was ≥140 Hz. This review provides evidence that tES has substantial effects on CSE in healthy individuals for a range of stimulus parameters.
许多研究探讨了经颅电刺激（tES）的影响 - 包括阳极经颅直流电刺激（a-tDCS）、阴极经颅直流电刺激（c-tDCS）、经颅交流电刺激（tACS）、经颅随机噪声刺激（tRNS）和经颅脉冲电流刺激（tPCS） - 对健康人群的皮质脊髓兴奋性（CSE）的影响。然而，这些技术的疗效及其产生强大效果的最佳参数尚未得到研究。因此，本系统评价的目的是整合当前关于各种参数的 a-tDCS、c-tDCS、tACS、tRNS 和 tPCS 对健康人初级运动皮层（M1）的 CSE 的影响的知识。对 1990 年 1 月至 2017 年 2 月期间发表的相关研究进行了主要电子数据库搜索；确定了 126 篇文章，并使用 RevMan 软件提取和分析其结果。荟萃分析显示，在优势侧应用 a-tDCS 可显著增加 CSE（P<0.01），并且 a-tDCS 的疗效取决于电流密度和应用持续时间。在非优势侧刺激 M1 也获得了类似的结果（P=0.003）。a-tDCS 的效果在 24 小时后显著降低（P=0.006）。荟萃分析还显示，c-tDCS 后 CSE 显著降低（P<0.001），tRNS 后（P=0.03）和 tPCS 后（P=0.01）显著增加。然而，只有当刺激频率≥140 Hz 时，tACS 对 CSE 的影响才具有统计学意义。本综述提供了证据表明，tES 对健康个体的 CSE 具有实质性影响，适用于一系列刺激参数。
