IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS113, Ctr. Casazza, 98124, Messina, Italy.
Neurol Sci. 2021 Jun;42(6):2191-2209. doi: 10.1007/s10072-021-05187-1. Epub 2021 Mar 23.
The cerebellum plays an important role in motor, cognitive, and affective functions owing to its dense interconnections with basal ganglia and cerebral cortex. This review aimed at summarizing the non-invasive cerebellar stimulation (NICS) approaches used to modulate cerebellar output and treat cerebellar dysfunction in the motor domain.
The utility of NICS in the treatment of cerebellar and non-cerebellar neurological diseases (including Parkinson's disease, dementia, cerebellar ataxia, and stroke) is discussed. NICS induces meaningful clinical effects from repeated sessions alone in both cerebellar and non-cerebellar diseases. However, there are no conclusive data on this issue and several concerns need to be still addressed before NICS could be considered a valuable, standard therapeutic tool.
Even though some challenges must be overcome to adopt NICS in a wider clinical setting, this tool might become a useful strategy to help patients with lesions in the cerebellum and cerebral areas that are connected with the cerebellum whether one could enhance cerebellar activity with the intention of facilitating the cerebellum and the entire, related network, rather than attempting to facilitate a partially damaged cortical region or inhibiting the homologs' contralateral area. The different outcome of each approach would depend on the residual functional reserve of the cerebellum, which is confirmed as a critical element to be probed preliminary in order to define the best patient-tailored NICS.
由于小脑与基底神经节和大脑皮层之间有着密集的相互连接，因此在运动、认知和情感功能方面发挥着重要作用。本综述旨在总结用于调节小脑输出和治疗运动领域小脑功能障碍的非侵入性小脑刺激（NICS）方法。
讨论了 NICS 在治疗小脑和非小脑神经疾病（包括帕金森病、痴呆、小脑共济失调和中风）中的应用。NICS 在小脑和非小脑疾病中，仅通过重复疗程就能产生有意义的临床效果。然而，关于这个问题还没有确凿的数据，在 NICS 被认为是一种有价值的标准治疗工具之前，还有几个问题需要解决。
尽管在更广泛的临床环境中采用 NICS 还需要克服一些挑战，但这种工具可能成为一种有用的策略，可以帮助患有小脑和与小脑相连的大脑区域损伤的患者，无论是通过增强小脑活动来促进小脑和整个相关网络，还是试图促进部分受损的皮质区域或抑制同源对侧区域。每种方法的不同结果将取决于小脑的剩余功能储备，这已被证实是一个关键因素，需要在初步阶段进行探究，以便确定最适合患者的 NICS。
