经 tDCS 康复治疗后帕金森病患者黑质内神经黑色素敏感区增加：病例报告。

A Parkinson's disease patient displaying increased neuromelanin-sensitive areas in the substantia nigra after rehabilitation with tDCS: a case report.

机构信息

Department of Rehabilitation, Toyama University Hospital, Toyama, Japan.

Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan.

出版信息

Neurocase. 2021 Oct;27(5):407-414. doi: 10.1080/13554794.2021.1975768. Epub 2021 Sep 10.

DOI:10.1080/13554794.2021.1975768

PMID:34503372

Abstract

Previous studies have reported that transcranial direct current stimulation (tDCS) of the frontal polar area (FPA) ameliorated motor disability in patients with Parkinson's disease (PD). Here we report changes in neuromelanin (NM) imaging of dopaminergic neurons before and after rehabilitation combined with anodal tDCS over the FPA for 2 weeks in a PD patient. After the intervention, the patient showed clinically meaningful improvements while the NM-sensitive area in the SN increased by 18.8%. This case study is the first report of NM imaging of the SN in a PD patient who received tDCS. FPA: front polar area; PD: Parkinson's disease; NM: neuromelanin; DCI: DOPA decarboxylase inhibitor; STEF: simple test for evaluating hand function; TUG: timed up and go test; TMT: trail-making test; SN: substantia nigra; NM-MRI: neuromelanin magnetic resonance imaging; MCID: the minimal clinically important difference; SNpc: substantia nigra pars compacta; VTA: ventral tegmental area; LC: locus coeruleus; PFC: prefrontal cortex; M1: primary motor cortex; MDS: Movement Disorder Society; MIBG: I-metaiodobenzylguanidine; SBR: specific binding ratio; SPECT: single-photon emission computed tomography; DAT: dopamine transporter; NIBS: noninvasive brain stimulation; tDCS: transcranial direct current stimulation; MAOB: monoamine oxidase B; DCI: decarboxylase inhibitor; repetitive transcranial magnetic stimulation: rTMS; diffusion tensor imaging: DTI; arterial spin labeling: ASL.

摘要

先前的研究报告表明，经颅直流电刺激（tDCS）于额极区（FPA）可改善帕金森病（PD）患者的运动障碍。在此，我们报告了一位 PD 患者在接受为期 2 周的 FPA 阳极 tDCS 联合康复治疗前后，多巴胺能神经元神经黑色素（NM）成像的变化。干预后，患者的临床症状有明显改善，同时 SN 中 NM 敏感区增加了 18.8%。这项病例研究首次报告了接受 tDCS 的 PD 患者 SN 的 NM 成像。FPA：front polar area；PD：Parkinson's disease；NM：neuromelanin；DCI：DOPA decarboxylase inhibitor；STEF：simple test for evaluating hand function；TUG：timed up and go test；TMT：trail-making test；SN：substantia nigra；NM-MRI：neuromelanin magnetic resonance imaging；MCID：the minimal clinically important difference；SNpc：substantia nigra pars compacta；VTA：ventral tegmental area；LC：locus coeruleus；PFC：prefrontal cortex；M1：primary motor cortex；MDS：Movement Disorder Society；MIBG：I-metaiodobenzylguanidine；SBR：specific binding ratio；SPECT：single-photon emission computed tomography；DAT：dopamine transporter；NIBS：noninvasive brain stimulation；tDCS：transcranial direct current stimulation；MAOB：monoamine oxidase B；DCI：decarboxylase inhibitor；repetitive transcranial magnetic stimulation：rTMS；diffusion tensor imaging：DTI；arterial spin labeling：ASL。