Department of Neurology, NYU Langone Health, New York, NY, USA.
Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy.
Ann Clin Transl Neurol. 2020 Nov;7(11):2310-2319. doi: 10.1002/acn3.51224. Epub 2020 Oct 20.
To evaluate whether multiple sessions of transcranial direct current stimulation (tDCS) applied to the primary motor (M1) cortex paired with aerobic exercise can improve walking functions in multiple sclerosis (MS).
MS participants were recruited for a double-blind, parallel-arm, randomized, sham-controlled trial and assigned to 10 sessions (5 d/wk for 2 weeks) of either active or sham tDCS paired with unloaded cycling for 20 minutes. Stimulation was administered over the left M1 cortex (2.5 mA; anode over C3/cathode over FP2). Gait spatiotemporal parameters were assessed using a wearable inertial sensor (10-meter and 2-minute walking tests). Measurements were collected at baseline, end of tDCS intervention, and 4-week postintervention to test for duration of any benefits.
A total of 15 participants completed the study, nine in the active and six in the sham condition. The active and sham groups were matched according to gender (50% vs. 40% female), neurologic disability (median EDSS 5.5 vs. 5), and age (mean 52.1 ± 12.9 vs. 53.7 ± 9.8 years). The active group had a significantly greater increase in gait speed (0.87 vs. 1.20 m/s, p < 0.001) and distance covered during the 2-minute walking test (118.53 vs. 133.06 m, p < 0.001) at intervention end compared to baseline. At 4-week follow-up, these improvements were maintained (baseline vs. follow-up: gait speed 0.87 vs. 1.18 m/s, p < 0.001; distance traveled 118.53 vs. 143.82 m, p < 0.001).
Multiple sessions of tDCS paired with aerobic exercise lead to cumulative and persisting improvements in walking and endurance in patients with MS.
评估经颅直流电刺激（tDCS）联合有氧运动对原发性运动皮质（M1）的多次治疗是否能改善多发性硬化症（MS）患者的步行功能。
本研究招募了多发性硬化症患者，进行了一项双盲、平行臂、随机、假对照试验，并将其分为主动 tDCS 组和假 tDCS 组，两组均接受 10 次治疗（每周 5 天，连续 2 周），同时进行无负荷自行车运动 20 分钟。刺激施加于左侧 M1 皮质（2.5 mA；阳极置于 C3，阴极置于 FP2）。使用可穿戴惯性传感器（10 米和 2 分钟步行测试）评估步态时空参数。在基线、tDCS 干预结束时和干预后 4 周进行测量，以检测任何获益的持续时间。
共有 15 名参与者完成了研究，其中 9 名在主动组，6 名在假刺激组。主动组和假刺激组在性别（50%对 40%女性）、神经功能缺损（中位数 EDSS 5.5 对 5）和年龄（平均 52.1±12.9 对 53.7±9.8 岁）方面相匹配。与基线相比，主动组在干预结束时的步行速度（0.87 对 1.20 m/s，p<0.001）和 2 分钟步行测试中覆盖的距离（118.53 对 133.06 m，p<0.001）有显著增加。在 4 周随访时，这些改善仍得以维持（基线与随访：步行速度 0.87 对 1.18 m/s，p<0.001；行走距离 118.53 对 143.82 m，p<0.001）。
tDCS 联合有氧运动的多次治疗可导致 MS 患者的步行和耐力得到持续的累积改善。
