θ 爆发刺激联合前额叶皮层经颅直流电刺激的联合效应：一项采用 99mTc-ECD SPECT 的随机、双盲、假刺激对照试验的研究方案。

Combined effects of theta-burst stimulation with transcranial direct current stimulation of the prefrontal cortex: study protocol of a randomized, double-blinded, sham-controlled trial using 99mTc-ECD SPECT.

机构信息

Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.

Departamento de Medicina Interna, Faculdade de Medicina, USP, São Paulo, SP, Brazil.

出版信息

Trends Psychiatry Psychother. 2021 Oct-Dec;43(4):293-301. doi: 10.47626/2237-6089-2020-0110. Epub 2021 Feb 24.

DOI:10.47626/2237-6089-2020-0110

PMID:34985846

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8835391/

Abstract

INTRODUCTION

Non-invasive brain stimulation (NIBS) as monotherapy has been increasingly used to enhance the activity of brain networks. However, it is unclear whether a combination of distinct NIBS approaches could enhance prefrontal cortical (PFC) activity.

OBJECTIVE

We propose to investigate the combined and standalone effects of two NIBS modalities on the PFC through a working memory task, single photon emission computed tomography (SPECT), and salivary cortisol. We hypothesize that the combined protocol will provoke greater changes in the collected measures compared to the remining protocols.

METHODS

A randomized, double-blind, sham-controlled, full-factorial design will be conducted. The effects of transcranial direct current stimulation (tDCS) and intermittent theta-burst stimulation (iTBS) will be investigated over four different sessions (sham tDCS + sham iTBS, anodal tDCS + sham iTBS, anodal tDCS + active iTBS and sham tDCS + active iTBS) in 30 healthy adult volunteers. A 99mTc-ethylene cysteine dimer (99mTC-ECD) will be administered during the NIBS session and neuroimaging will be acquired within one hour. Salivary cortisol will be collected before and after each session and an n-back working memory task will be applied after the end of each NIBS session. The outcomes will be cerebral perfusion alterations (99mTC-ECD SPECT), accuracy and reaction time in the n-back task, and changes in salivary cortisol level.

CONCLUSION

The results from this trial can guide future therapeutic protocols for NIBS treatments stimulating the PFC by demonstrating that the combination of NIBS techniques is feasible, tolerable, and can lead to greater enhancement of PFC activity.

摘要

简介

非侵入性脑刺激（NIBS）作为单一疗法已越来越多地用于增强大脑网络的活动。然而，尚不清楚两种不同的 NIBS 方法的组合是否可以增强前额皮质（PFC）的活性。

目的

我们拟通过工作记忆任务、单光子发射计算机断层扫描（SPECT）和唾液皮质醇来研究两种 NIBS 方式联合和单独对 PFC 的影响。我们假设联合方案将引起所收集的测量值比剩余方案发生更大的变化。

方法

将进行随机、双盲、假对照、全因子设计。将在四个不同的疗程中（假 tDCS+假 iTBS、阳极 tDCS+假 iTBS、阳极 tDCS+活跃 iTBS 和假 tDCS+活跃 iTBS），对 30 名健康成年志愿者进行经颅直流电刺激（tDCS）和间歇性经颅磁刺激（iTBS）的影响研究。在 NIBS 疗程期间将给予 99mTc-乙撑半胱氨酸二聚体（99mTC-ECD），并在一小时内进行神经影像学检查。在每次疗程前后收集唾液皮质醇，并在每次 NIBS 疗程结束后进行 n-back 工作记忆任务。结果将是大脑灌注改变（99mTC-ECD SPECT）、n-back 任务的准确性和反应时间，以及唾液皮质醇水平的变化。