1 Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA.
2 Beth Israel Deaconess Medical Center, Boston, MA, USA.
Neurorehabil Neural Repair. 2018 Sep;32(9):788-798. doi: 10.1177/1545968318792616. Epub 2018 Aug 22.
To determine the effects of a transcranial direct current stimulation (tDCS) intervention with the anode placed over the left dorsolateral prefrontal cortex (dlPFC) and cathode over the right supraorbital region, on cognition, mobility, and "dual-task" standing and walking in older adults with mild-to-moderate motor and cognitive impairments.
A double-blinded, block-randomized, sham-controlled trial was conducted in 18 nondemented, ambulatory adults aged ⩾65 years with slow walking speed (⩽1.0 m/s) and "executive" dysfunction (Trail Making Test B score ⩽25th percentile of age- and education-matched norms). Interventions included ten 20-minute sessions of tDCS or sham stimulation. Cognition, mobility, and dual-task standing and walking were assessed at baseline, postintervention, and 2 weeks thereafter. Dual tasking was also assessed immediately before and after the first tDCS session.
Intervention compliance was high (mean ± SD = 9.5 ± 1.1 sessions) and no unexpected or serious side effects were reported. tDCS, compared with sham, induced improvements in the Montreal Cognitive Assessment total score ( P = .03) and specifically within the executive function subscore of this test ( P = .002), and in several metrics of dual-task standing and walking ( P < .05). Each of these effects persisted for 2 weeks. tDCS had no effect on the Timed Up-and-Go test of mobility or the Geriatric Depression Scale. Those participants who exhibited larger improvements in dual-task standing posture following the first tDCS session exhibited larger cognitive-motor improvements following 2 weeks of tDCS ( P < .04).
tDCS intervention designed to stimulate the left dorsolateral prefrontal cortex may improve executive function and dual tasking in older adults with functional limitations.
确定将阳极置于左背外侧前额叶皮层（dlPFC）和阴极置于右眶上区域的经颅直流电刺激（tDCS）干预对轻度至中度运动和认知障碍的老年人的认知、移动性以及“双重任务”站立和行走的影响。
在 18 名非痴呆、能行走且年龄 ⩾65 岁的成年人中进行了一项双盲、随机分组、假刺激对照试验，这些成年人的步行速度较慢（⩽1.0m/s）且存在“执行”功能障碍（Trail 制作测试 B 分数 ⩽年龄和教育匹配标准的第 25 个百分位数）。干预措施包括十次 20 分钟的 tDCS 或假刺激。在基线、干预后和之后的 2 周评估认知、移动性以及双重任务站立和行走。在第一次 tDCS 治疗前后也立即评估双重任务。
干预的依从性很高（平均值±标准差=9.5±1.1 次），并且没有报告任何意外或严重的副作用。与假刺激相比，tDCS 可改善蒙特利尔认知评估总分（P=.03），特别是在该测试的执行功能子评分中（P=.002），以及在双重任务站立和行走的几个指标中（P <.05）。这些效果均持续 2 周。tDCS 对移动性的“起立行走测试”或老年抑郁量表没有影响。那些在第一次 tDCS 治疗后双重任务站立姿势改善较大的参与者，在 2 周的 tDCS 治疗后认知运动能力的改善更大（P <.04）。
旨在刺激左背外侧前额叶皮层的 tDCS 干预可能会改善功能受限的老年人的执行功能和双重任务能力。
