经颅直流电刺激联合A型肉毒杆菌神经毒素注射治疗多发性硬化症上肢意向性震颤：一例报告

Transcranial Direct Current Stimulation Combined with Botulinum Neurotoxin Type A Injections for Treatment of Upper Limb Intention Tremor in Multiple Sclerosis: A Case Report.

作者信息

Facciorusso Salvatore, Spina Stefania, Santoro Luigi, Cinone Nicoletta, Baricich Alessio, Ciritella Chiara, Fiore Pietro, Santamato Andrea

机构信息

Spasticity and Movement Disorders "ReSTaRt" Unit, Physical Medicine and Rehabilitation Section, Policlinico Riuniti, University of Foggia, Foggia, Italy.

Physical and Rehabilitation Section, Policlinico Riuniti, Foggia, Italy.

出版信息

Case Rep Neurol. 2021 Feb 15;13(1):92-99. doi: 10.1159/000512324. eCollection 2021 Jan-Apr.

DOI:10.1159/000512324

PMID:33708100

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7923919/

Abstract

Upper limb intention tremor is a common cause of disability in multiple sclerosis (MS). Transcranial direct current stimulation (tDCS) is an emerging form of brain stimulation used to improve sensorimotor impairments in many neurological disorders. Here, we describe a combined therapeutic approach with botulinum neurotoxin type A (BoNT-A) and tDCS for the treatment of upper limb tremor in a patient with MS. We administered a cathodal tDCS 15 days after the injections of BoNT-A. Both post-injection and post-stimulation evaluation revealed a considerable improvement of the tremor. This approach positively affected the patient's activities of daily living. Our case report shows a safe and beneficial effect of tDCS in the treatment of action tremor in MS especially as a possible adjunctive synergic treatment with BoNT-A injections.

摘要

上肢意向性震颤是多发性硬化症（MS）导致残疾的常见原因。经颅直流电刺激（tDCS）是一种新兴的脑刺激形式，用于改善许多神经系统疾病中的感觉运动障碍。在此，我们描述了一种联合使用A型肉毒杆菌神经毒素（BoNT-A）和tDCS治疗MS患者上肢震颤的治疗方法。在注射BoNT-A 15天后，我们给予了阴极tDCS。注射后和刺激后的评估均显示震颤有显著改善。这种方法对患者的日常生活活动产生了积极影响。我们的病例报告显示，tDCS在治疗MS的动作性震颤方面具有安全有益的效果，特别是作为与BoNT-A注射联合使用的可能的辅助协同治疗方法。