New York University Langone Health, New York, USA.
Tufts School of Medicine, Boston, USA.
J Neuroeng Rehabil. 2018 Dec 7;15(1):114. doi: 10.1186/s12984-018-0457-9.
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has been shown to improve common symptoms of neurological disorders like depressed mood, fatigue, motor deficits and cognitive dysfunction. tDCS requires daily treatment sessions in order to be effective. We developed a remotely supervised tDCS (RS-tDCS) protocol for participants with multiple sclerosis (MS) to increase accessibility of tDCS, reducing clinician, patient, and caregiver burden. The goal of this protocol is to facilitate home use for larger trials with extended treatment periods. In this study we determine the generalizability of RS-tDCS paired with cognitive training (CT) by testing its feasibility in participants with Parkinson's disease (PD).
Following the methods in our MS protocol development, we enrolled sixteen participants (n = 12 male, n = 4 female; mean age 66 years) with PD to complete ten open-label sessions of RS-tDCS paired with CT (2.0 mA × 20 min) at home under the remote supervision of a trained study technician. Tolerability data were collected before, during, and after each individual session. Baseline and follow-up measures included symptom inventories (fatigue and sleep) and cognitive assessments.
RS-tDCS was feasible and tolerable for patients with PD, with at-home access leading to high protocol compliance. Side effects were mostly limited to mild sensations of transient itching and burning under the electrode sites. Similar to prior finding sin MS, we found preliminary efficacy for improvement of fatigue and cognitive processing speed in PD.
RS-tDCS paired with CT is feasible for participants with PD to receive at home treatment. Signals of benefit for reduced fatigue and improved cognitive processing speed are consistent across the PD and MS samples. RS-tDCS can be generalized to provide tDCS to a range of patients with neurologic disorders for at-home rehabilitation.
ClinicalTrials.gov Identifier: NCT02746705 . Registered April 21st 2016.
经颅直流电刺激（tDCS）是一种非侵入性脑刺激技术，已被证明可改善抑郁、疲劳、运动缺陷和认知功能障碍等神经疾病的常见症状。tDCS 需要每日治疗才能有效。我们为多发性硬化症（MS）患者开发了一种远程监督 tDCS（RS-tDCS）方案，以提高 tDCS 的可及性，减轻临床医生、患者和护理人员的负担。该方案的目标是通过增加治疗期来促进更大规模试验的家庭使用。在这项研究中，我们通过测试其在帕金森病（PD）患者中的可行性，确定了 RS-tDCS 与认知训练（CT）相结合的通用性。
根据我们在 MS 方案开发中的方法，我们招募了 16 名参与者（n=12 名男性，n=4 名女性；平均年龄 66 岁），让他们在家中在经过培训的研究技术员的远程监督下完成 10 次开放标签的 RS-tDCS 与 CT（2.0 mA×20 分钟）联合治疗。在每次单独治疗前后都收集了耐受性数据。基线和随访测量包括症状量表（疲劳和睡眠）和认知评估。
RS-tDCS 对 PD 患者是可行且可耐受的，家庭访问导致了很高的方案依从性。副作用主要局限于电极部位短暂的瘙痒和烧灼感。与 MS 中的先前发现相似，我们发现 PD 中疲劳和认知处理速度的改善有初步疗效。
RS-tDCS 与 CT 联合用于 PD 患者在家中接受治疗是可行的。在 PD 和 MS 样本中，减轻疲劳和提高认知处理速度的信号是一致的。RS-tDCS 可以推广到为一系列患有神经疾病的患者提供家庭康复治疗。
ClinicalTrials.gov 标识符：NCT02746705。于 2016 年 4 月 21 日注册。
