经颅直流电刺激不同靶点对帕金森病患者皮质活动和双任务步行的调节作用：一项双盲随机对照试验
Transcranial Direct Current Stimulation on Different Targets to Modulate Cortical Activity and Dual-Task Walking in Individuals With Parkinson's Disease: A Double Blinded Randomized Controlled Trial.
作者信息
Wong Pei-Ling, Yang Yea-Ru, Huang Shih-Fong, Fuh Jong-Ling, Chiang Han-Lin, Wang Ray-Yau
机构信息
Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Division of Nerve Repair, Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan.
出版信息
Front Aging Neurosci. 2022 Feb 7;14:807151. doi: 10.3389/fnagi.2022.807151. eCollection 2022.
BACKGROUND
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation to modulate cortical activity for improving motor function. However, the information of tDCS stimulation on different brain regions for dual-task walking and cortical modulation in Parkinson's disease (PD) has not yet been compared.
OBJECTIVE
The objective of this study was to investigate the effects of different tDCS targets on dual-task gait performance and cortical activity in patients with PD.
METHODS
A total of 36 participants were randomly assigned to primary motor cortex (M1) tDCS, dorsal lateral prefrontal cortex (DLPFC) tDCS, cerebellum tDCS, or Sham tDCS group. Each group received 20 min of tDCS stimulation, except for the Sham group. Gait performance was measured by the GAITRite system during dual-task walking and single walking. Corticomotor activity of the tibialis anterior (TA) was measured using transcranial magnetic stimulation (TMS). The functional mobility was assessed using the timed up and go (TUG) test.
RESULTS
All participants showed no significant differences in baseline data. Following the one session of tDCS intervention, M1 ( = 0.048), DLPFC ( < 0.001), and cerebellum ( = 0.001) tDCS groups demonstrated significant improvements in dual-task gait speed compared with a pretest. The time × group interaction [(3, 32) = 5.125, = 0.005] was detected in dual-task walking speed. The Tukey's test showed that the differences in gait speed were between the Sham tDCS group and the DLPFC tDCS group ( = 0.03). Moreover, DLPFC tDCS also increased the silent period (SP) more than M1 tDCS ( = 0.006) and Sham tDCS ( = 0.002).
CONCLUSION
The results indicate that DLPFC tDCS exerted the most beneficial effects on dual-task walking and cortical modulation in participants with PD.
CLINICAL TRIAL REGISTRATION
[http://www.thaiclinicaltrials.org/show/TCTR20200909005], Thai Clinical Trials Registry [TCTR20200909005].
背景
经颅直流电刺激（tDCS）是一种非侵入性脑刺激，用于调节皮层活动以改善运动功能。然而，尚未比较tDCS刺激帕金森病（PD）患者不同脑区对双任务步行和皮层调制的影响。
目的
本研究旨在探讨不同tDCS靶点对PD患者双任务步态表现和皮层活动的影响。
方法
总共36名参与者被随机分配到初级运动皮层（M1）tDCS组、背外侧前额叶皮层（DLPFC）tDCS组、小脑tDCS组或假tDCS组。除假刺激组外，每组接受20分钟的tDCS刺激。在双任务步行和单任务步行期间，使用GAITRite系统测量步态表现。使用经颅磁刺激（TMS）测量胫前肌（TA）的皮质运动活动。使用计时起立行走（TUG）测试评估功能移动性。
结果
所有参与者的基线数据无显著差异。在一次tDCS干预后，M1（P = 0.048）、DLPFC（P < 0.001）和小脑（P = 0.001）tDCS组与预测试相比，双任务步态速度有显著改善。在双任务步行速度中检测到时间×组交互作用[F(3, 32) = 5.125, P = 0.005]。Tukey检验显示，假tDCS组和DLPFC tDCS组之间的步态速度存在差异（P = 0.03）。此外，DLPFC tDCS比M1 tDCS（P = 0.006）和假tDCS（P = 0.002）更能增加静息期（SP）。
结论
结果表明，DLPFC tDCS对PD参与者的双任务步行和皮层调制产生了最有益的影响。
临床试验注册
[http://www.thaiclinicaltrials.org/show/TCTR20200909005]泰国临床试验注册中心[TCTR20200909005]
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