Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Biomedical Engineering, The City College of New York, New York, NY, USA.
Brain Stimul. 2019 Sep-Oct;12(5):1222-1228. doi: 10.1016/j.brs.2019.06.003. Epub 2019 Jun 4.
Although single or multiple sessions of transcranial direct current stimulation (tDCS) on the prefrontal cortex over a few weeks improved cognition in patients with Alzheimer's disease (AD), effects of repeated tDCS over longer period and underlying neural correlates remain to be elucidated.
This study investigated changes in cognitive performances and regional cerebral metabolic rate for glucose (rCMRglc) after administration of prefrontal tDCS over 6 months in early AD patients.
Patients with early AD were randomized to receive either active (n = 11) or sham tDCS (n = 7) over the dorsolateral prefrontal cortex (DLPFC) at home every day for 6 months (anode F3/cathode F4, 2 mA for 30 min). All patients underwent neuropsychological tests and brain F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) scans at baseline and 6-month follow-up. Changes in cognitive performances and rCMRglc were compared between the two groups.
Compared to sham tDCS, active tDCS improved global cognition measured with Mini-Mental State Examination (p for interaction = 0.02) and language function assessed by Boston Naming Test (p for interaction = 0.04), but not delayed recall performance. In addition, active tDCS prevented decreases in executive function at a marginal level (p for interaction < 0.10). rCMRglc in the left middle/inferior temporal gyrus was preserved in the active group, but decreased in the sham group (p for interaction < 0.001).
Daily tDCS over the DLPFC for 6 months may improve or stabilize cognition and rCMRglc in AD patients, suggesting the therapeutic potential of repeated at-home tDCS.
尽管在数周内对前额叶皮层进行单次或多次经颅直流电刺激(tDCS)可改善阿尔茨海默病(AD)患者的认知功能,但反复进行 tDCS 治疗更长时间的效果及其潜在的神经相关性仍有待阐明。
本研究旨在探讨早期 AD 患者接受前额叶 tDCS 治疗 6 个月后认知表现和局部脑葡萄糖代谢率(rCMRglc)的变化。
将早期 AD 患者随机分为接受真刺激(n=11)或假刺激(n=7)组,真刺激组在家中每天接受双侧额上回/额中回(F3/F4)的经颅直流电刺激(阳极 F3/阴极 F4,2 mA 刺激 30 分钟),共 6 个月。所有患者在基线和 6 个月随访时均接受神经心理学测试和脑 F-氟代-2-脱氧葡萄糖正电子发射断层扫描(FDG-PET)检查。比较两组间认知表现和 rCMRglc 的变化。
与假刺激组相比,真刺激组在简易精神状态检查(p 交互作用=0.02)和波士顿命名测试(p 交互作用=0.04)中语言功能方面的整体认知能力得到改善,但在延迟回忆方面无显著差异。此外,真刺激组在边缘水平上可预防执行功能的下降(p 交互作用<0.10)。真刺激组左侧颞中/下回的 rCMRglc 得到保持,而假刺激组则出现下降(p 交互作用<0.001)。
6 个月内每天对前额叶皮层进行经颅直流电刺激可能改善或稳定 AD 患者的认知和 rCMRglc,提示重复家庭经颅直流电刺激具有治疗潜力。