Chiang Hsueh-Sheng, Shakal Scott, Vanneste Sven, Kraut Michael, Hart John
Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, United States.
School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States.
Front Neurol. 2021 Jul 16;12:678518. doi: 10.3389/fneur.2021.678518. eCollection 2021.
We report a patient who has cognitive sequalae including verbal retrieval deficits after severe traumatic brain injury (TBI). The cortico-caudate-thalamic circuit involving the pre-Supplementary Motor Area (pre-SMA) has been proposed to underlie verbal retrieval functions. We hypothesized that High Definition-transcranial Direct Current Stimulation (HD-tDCS) targeting the pre-SMA would selectively modulate this circuit to remediate verbal retrieval deficits. After the patient underwent 10 sessions of 20 min of 1 mA HD-tDCS targeting the pre-SMA, we documented significant improvements for verbal fluency and naming, and for working memory and executive function tasks that involve the frontal lobes. The effects persisted for up to 14 weeks after completion of HD-tDCS treatment. We also demonstrated normalization of the event-related potentials suggesting modulation of the underlying neural circuit. Our study implicates that region-specific non-invasive brain stimulation, such as HD-tDCS, serves as a potential individualized therapeutic tool to treat cognitive deficits by inducing longer-lasting neuroplasticity even in the chronic phase of TBI.
我们报告了一名严重创伤性脑损伤（TBI）后出现包括言语检索缺陷在内的认知后遗症的患者。有人提出，涉及补充运动区前区（pre-SMA）的皮质-尾状核-丘脑回路是言语检索功能的基础。我们假设，针对pre-SMA的高清经颅直流电刺激（HD-tDCS）将选择性地调节该回路，以纠正言语检索缺陷。在该患者接受了10次、每次20分钟、1毫安的针对pre-SMA的HD-tDCS治疗后，我们记录到其言语流畅性和命名能力，以及涉及额叶的工作记忆和执行功能任务有显著改善。这些效果在HD-tDCS治疗完成后持续了长达14周。我们还证明了事件相关电位的正常化，表明潜在神经回路受到了调节。我们的研究表明，区域特异性非侵入性脑刺激，如HD-tDCS，即使在TBI的慢性期，也可作为一种潜在的个体化治疗工具，通过诱导更持久的神经可塑性来治疗认知缺陷。
