Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
Transl Neurodegener. 2021 Jun 29;10(1):22. doi: 10.1186/s40035-021-00245-2.
Gait problems are an important symptom in Parkinson's disease (PD), a progressive neurodegenerative disease. Transcranial direct current stimulation (tDCS) is a neuromodulatory intervention that can modulate cortical excitability of the gait-related regions. Despite an increasing number of gait-related tDCS studies in PD, the efficacy of this technique for improving gait has not been systematically investigated yet. Here, we aimed to systematically explore the effects of tDCS on gait in PD, based on available experimental studies.
Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, PubMed, Web of Science, Scopus, and PEDro databases were searched for randomized clinical trials assessing the effect of tDCS on gait in patients with PD.
Eighteen studies were included in this systematic review. Overall, tDCS targeting the motor cortex and supplementary motor area bilaterally seems to be promising for gait rehabilitation in PD. Studies of tDCS targeting the dorosolateral prefrontal cortex or cerebellum showed more heterogeneous results. More studies are needed to systematically compare the efficacy of different tDCS protocols, including protocols applying tDCS alone and/or in combination with conventional gait rehabilitation treatment in PD.
tDCS is a promising intervention approach to improving gait in PD. Anodal tDCS over the motor areas has shown a positive effect on gait, but stimulation of other areas is less promising. However, the heterogeneities of methods and results have made it difficult to draw firm conclusions. Therefore, systematic explorations of tDCS protocols are required to optimize the efficacy.
步态问题是帕金森病（PD）的一个重要症状，PD 是一种进行性神经退行性疾病。经颅直流电刺激（tDCS）是一种神经调节干预措施，可以调节与步态相关的区域的皮质兴奋性。尽管 PD 中与步态相关的 tDCS 研究越来越多，但该技术改善步态的疗效尚未得到系统研究。在这里，我们旨在根据现有实验研究，系统探讨 tDCS 对 PD 患者步态的影响。
使用 PRISMA（系统评价和荟萃分析的首选报告项目）方法，检索了 PubMed、Web of Science、Scopus 和 PEDro 数据库中评估 tDCS 对 PD 患者步态影响的随机临床试验。
本系统评价共纳入 18 项研究。总体而言，双侧运动皮质和辅助运动区的 tDCS 似乎对 PD 的步态康复有希望。针对背外侧前额叶皮质或小脑的 tDCS 研究结果则更为混杂。需要更多的研究来系统比较不同 tDCS 方案的疗效，包括单独应用 tDCS 以及/或与 PD 中的常规步态康复治疗相结合的方案。
tDCS 是改善 PD 步态的一种很有前途的干预方法。运动区的阳极 tDCS 对步态有积极影响，但刺激其他区域的效果则不太理想。然而，方法和结果的异质性使得很难得出明确的结论。因此，需要对 tDCS 方案进行系统探索，以优化疗效。
