Workman Craig D, Fietsam Alexandra C, Rudroff Thorsten
Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA.
Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
Brain Sci. 2020 Jul 20;10(7):467. doi: 10.3390/brainsci10070467.
Transcranial direct current stimulation (tDCS) is accompanied by transient sensations (e.g., tingling, itching, burning), which may affect treatment outcomes or break the blinding of the study protocol. Assessing tolerability and blinding is integral to providing ample evidence of a "real effect" from the applied stimulation and dispelling the possibility of placebo effects. People with Parkinson's disease (PwPD) endure many motor and non-motor symptoms that might be amenable to tDCS. However, because the disease also affects sensation capabilities, these subjects might report tolerability and blinding differently than other cohorts. Therefore, the purpose of this review was to aggregate the tolerability and blinding reports of tDCS studies in PwPD and recommend a standard tolerability and blinding reporting practice. A literature search of the PubMed and Scopus databases from 1 January 2020 to 1 April 2020 was performed to identify publications that applied tDCS to PwPD. Seventy studies were potentially reviewable, but only 36 (nine with quantitative tolerability reports, 20 with qualitative tolerability reports, and seven that only reported blinding) provided sufficient information to be included in the review. Quantitative information on tDCS tolerability and blinding maintenance in PwPD is scarce, and future reviews and metanalyses should carefully consider the possibility of placebo effects in their included studies.
经颅直流电刺激（tDCS）会伴随短暂的感觉（如刺痛、瘙痒、灼烧感），这可能会影响治疗效果或破坏研究方案的盲法。评估耐受性和盲法对于提供充分证据证明所施加刺激产生的“真实效果”以及消除安慰剂效应的可能性至关重要。帕金森病患者（PwPD）忍受着许多可能适合tDCS治疗的运动和非运动症状。然而，由于该疾病也会影响感觉能力，这些受试者对耐受性和盲法的报告可能与其他队列不同。因此，本综述的目的是汇总PwPD中tDCS研究的耐受性和盲法报告，并推荐一种标准的耐受性和盲法报告做法。对2020年1月1日至2020年4月1日期间的PubMed和Scopus数据库进行文献检索，以确定将tDCS应用于PwPD的出版物。有70项研究可能可纳入综述，但只有36项（9项有定量耐受性报告，20项有定性耐受性报告，7项仅报告了盲法）提供了足够的信息可纳入综述。关于PwPD中tDCS耐受性和盲法维持的定量信息很少，未来的综述和荟萃分析应在其纳入的研究中仔细考虑安慰剂效应的可能性。
