Department of Neurology, Otto-von-Guericke-University Magdeburg, Leipziger Street 44, Magdeburg 39120, Germany.
Department of Neurology, Otto-von-Guericke-University Magdeburg, Leipziger Street 44, Magdeburg 39120, Germany; Center for Behavioral Brain Sciences (CBBS), Magdeburg 39106, Germany.
Clin Neurophysiol. 2021 Jul;132(7):1721-1732. doi: 10.1016/j.clinph.2021.02.391. Epub 2021 Mar 29.
Cognitive fatigability is a frequent symptom after sustained performance. Fatigability is evident in healthy subjects but is also often comorbid in several neuropsychiatric diseases. However, to date, clinical diagnostic almost solely relies on the self-reported subjective experience of fatigue. The goals of this present study were i) to complement the purely subjective fatigue diagnostic with objective electrophysiological fatigability parameters and ii) to prove the potential therapeutic application of transcranial direct current stimulation (tDCS) as a fatigability intervention.
We performed a pseudo-randomized, sham-controlled, parallel-group trial. Forty healthy participants received either anodal or sham tDCS over the left dorsolateral prefrontal cortex (DLPFC) while they performed an exhaustive cognitive task to induce cognitive fatigability. To assess fatigability changes, we analyzed variations of prepulse inhibition (PPI) and P50 suppression as well as frontomedial theta and occipital alpha power with time-on-task.
The task reliably induced subjective exhaustion in all participants. Furthermore, we confirmed fatigability-related increases in frontomedial theta and occipital alpha power throughout the task. Additionally, fatigability significantly reduced PPI as well as P50 sensory gating. Anodal tDCS over the left DLPFC successfully counteracted fatigability and reduced the fatigability-related increase in alpha power as well as the decline in both gating parameters.
Occipital alpha and sensorimotor/sensory gating are suitable parameters to assess the severity of fatigability objectively. Anodal tDCS can counteract fatigability and has therapeutic potential for the treatment of fatigability in neuropsychiatric diseases.
Fatigability can be objectively assessed by electrophysiological measures and attenuated by tDCS.
认知疲劳是持续表现后的常见症状。疲劳在健康受试者中很明显，但在几种神经精神疾病中也经常并发。然而，迄今为止，临床诊断几乎完全依赖于疲劳的自我报告主观体验。本研究的目的是 i）用客观的电生理疲劳参数补充纯主观疲劳诊断，ii）证明经颅直流电刺激（tDCS）作为疲劳干预的潜在治疗应用。
我们进行了一项伪随机、假对照、平行组试验。40 名健康参与者接受了左侧背外侧前额叶皮层（DLPFC）的阳极或假 tDCS，同时他们执行了一项详尽的认知任务以诱导认知疲劳。为了评估疲劳变化，我们分析了随着任务时间的变化，前脉冲抑制（PPI）和 P50 抑制以及额内侧θ和枕部α功率的变化。
该任务可靠地引起了所有参与者的主观疲劳。此外，我们证实了与疲劳相关的额内侧θ和枕部α功率在整个任务中的增加。此外，疲劳显著降低了 PPI 以及 P50 感觉门控。左侧 DLPFC 的阳极 tDCS成功地对抗了疲劳，并减少了与疲劳相关的α功率增加以及两种门控参数的下降。
枕部α和感觉运动/感觉门控是评估疲劳严重程度的合适客观参数。阳极 tDCS 可以对抗疲劳，并且对治疗神经精神疾病中的疲劳具有治疗潜力。
疲劳可以通过电生理测量来客观评估，并通过 tDCS 来减轻。
