经颅刺激增强进行性核上性麻痹患者的语言能力。
Language boosting by transcranial stimulation in progressive supranuclear palsy.
机构信息
From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY.
出版信息
Neurology. 2019 Aug 6;93(6):e537-e547. doi: 10.1212/WNL.0000000000007893. Epub 2019 Jul 3.
OBJECTIVE
To explore whether transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) can improve language capacities in patients with progressive supranuclear palsy (PSP).
METHODS
We used a sham-controlled double-blind crossover design to assess the efficiency of tDCS over the DLPFC in a cohort of 12 patients with PSP. In 3 separate sessions, we evaluated the ability to boost the left DLPFC via left-anodal (excitatory) and right-cathodal (inhibitory) tDCS, while comparing them to sham tDCS. Tasks assessing lexical access (letter fluency task) and semantic access (category judgment task) were applied immediately before and after the tDCS sessions to provide a marker of potential language modulation.
RESULTS
The comparison with healthy controls showed that patients with PSP were impaired on both tasks at baseline. Contrasting poststimulation vs prestimulation performance across tDCS conditions revealed language improvement in the category judgment task following right-cathodal tDCS, and in the letter fluency task following left-anodal tDCS. A computational finite element model of current distribution corroborated the intended effect of left-anodal and right-cathodal tDCS on the targeted DLPFC.
CONCLUSIONS
Our results demonstrate tDCS-driven language improvement in PSP. They provide proof-of-concept for the use of tDCS in PSP and set the stage for future multiday stimulation regimens, which might lead to longer-lasting therapeutic effects promoted by neuroplasticity.
CLASSIFICATION OF EVIDENCE
This study provides Class III evidence that for patients with PSP, tDCS over the DLPFC improves performance in some language tasks.
目的
探索经颅直流电刺激（tDCS）对背外侧前额叶皮质（DLPFC）是否能改善进行性核上性麻痹（PSP）患者的语言能力。
方法
我们采用假刺激对照、双盲交叉设计，评估了 tDCS 对 12 例 PSP 患者 DLPFC 的疗效。在 3 个单独的疗程中，我们评估了通过左阳极（兴奋）和右阴极（抑制）tDCS 刺激左 DLPFC 的能力，并将其与假刺激 tDCS 进行比较。在 tDCS 疗程前后，我们应用词汇检索任务（字母流畅性任务）和语义检索任务（类别判断任务），以提供潜在语言调节的标志物。
结果
与健康对照组相比，PSP 患者在基线时这两项任务均受损。在 tDCS 条件下，比较刺激后与刺激前的表现，发现右阴极 tDCS 后类别判断任务的语言改善，左阳极 tDCS 后字母流畅性任务的语言改善。电流分布的计算有限元模型证实了左阳极和右阴极 tDCS 对目标 DLPFC 的预期影响。
结论
我们的结果表明，tDCS 可驱动 PSP 患者的语言改善。它们为 tDCS 在 PSP 中的应用提供了概念验证，并为未来的多天刺激方案奠定了基础，这些方案可能会通过神经可塑性产生更持久的治疗效果。
证据分类
本研究提供了 III 级证据，表明对于 PSP 患者，DLPFC 的 tDCS 可改善某些语言任务的表现。
Zotero 插件