Turski Christopher A, Kessler-Jones Alanna, Chow Clara, Hermann Bruce, Hsu David, Jones Jana, Seeger Susanne K, Chappell Rick, Boly Melanie, Ikonomidou Chrysanthy
Department of Neurology, University of Wisconsin, Madison, WI, USA.
Departments of Statistics and Biostatistics/Medical Informatics, University of Wisconsin, Madison, WI, USA.
Restor Neurol Neurosci. 2017;35(6):631-642. doi: 10.3233/RNN-170757.
High definition transcranial direct current stimulation (HD-tDCS) has been administered over single brain regions for small numbers of sessions. Safety, feasibility and tolerability of HD-tDCS over multiple brain regions, multiple daily stimulations and long periods are not established.
We studied safety, feasibility and tolerability of daily HD-tDCS over 2-4 brain regions for 20 sessions in healthy adults.
Five healthy adults underwent physical and neurological examination, electrocardiogram (EKG), electroencephalogram (EEG) and cognitive screening (ImpACT) before, during and after HD-tDCS. Four networks (left/right temporoparietal and frontal) were stimulated in sequence (20 min each) using HD-tDCS in 20 daily sessions. Sessions 1-10 included sequential stimulation of both temporoparietal networks, sessions 11-15 stimulations of 4 networks and sessions 16-20 two daily stimulation cycles of 4 networks/cycle (1.5 mA/network). Side effects, ImpACT scores and EEG power spectrum were compared before and after HD-tDCS.
All subjects completed the trial. Adverse events were tingling, transient redness at the stimulation site, perception of continuing stimulation after end of session and one self-resolving headache. EEG power spectrum showed decreased delta power in frontal areas several days after HD-tDCS. While at the group level ImpACT scores did not differ before and after stimulations, we found a trend for correlation between decreased EEG delta power and individual improvements in ImpACT scores after HD-tDCS.
Prolonged, repeat daily stimulation of multiple brain regions using HD-tDCS is feasible and safe in healthy adults. Preliminary EEG results suggest that HD-tDCS may induce long lasting changes in excitability in the brain.
高清晰度经颅直流电刺激（HD-tDCS）已应用于单个脑区，且刺激次数较少。HD-tDCS在多个脑区、每日多次刺激以及长期刺激下的安全性、可行性和耐受性尚未确定。
我们研究了在健康成年人中，对2 - 4个脑区进行每日HD-tDCS，共20次刺激的安全性、可行性和耐受性。
5名健康成年人在HD-tDCS之前、期间和之后接受了体格检查、神经检查、心电图（EKG）、脑电图（EEG）和认知筛查（ImpACT）。使用HD-tDCS在20个每日疗程中依次刺激四个网络（左/右颞顶叶和额叶）（每个网络刺激20分钟）。第1 - 10个疗程包括对两个颞顶叶网络的顺序刺激，第11 - 15个疗程刺激四个网络，第16 - 20个疗程为四个网络/周期的两个每日刺激周期（每个网络1.5毫安）。比较HD-tDCS前后的副作用、ImpACT评分和EEG功率谱。
所有受试者均完成试验。不良事件包括刺痛、刺激部位短暂发红、疗程结束后仍有持续刺激感以及一例自行缓解的头痛。HD-tDCS数天后，EEG功率谱显示额叶区域的δ波功率降低。虽然在组水平上，刺激前后ImpACT评分没有差异，但我们发现HD-tDCS后EEG δ波功率降低与ImpACT评分的个体改善之间存在相关性趋势。
在健康成年人中，使用HD-tDCS对多个脑区进行长时间、重复的每日刺激是可行且安全的。初步的EEG结果表明，HD-tDCS可能会引起大脑兴奋性的持久变化。
