Lin Xiaoying, Zhang Yanming, Chen Xi, Wen Lifen, Duan Lian, Yang Lei
Department of Rehabilitation Medicine, The Second People's Hospital of Kunming, Yunnan Province, China.
School of Rehabilitation, Kunming Medical University, Yunnan Province, China.
Front Neurosci. 2023 Apr 11;17:1157920. doi: 10.3389/fnins.2023.1157920. eCollection 2023.
Increasing research has investigated the use of noninvasive brain stimulation (NIBS) on augmenting dual-task (DT) performance.
To investigate the effects of NIBS on DT performance in different populations.
Extensive electronic database search (from inception to November 20, 2022) was conducted in PubMed, Medline, Cochrane Library, Web of Science and CINAHL to identify randomized controlled trials (RCTs) that investigated the effects of NIBS on DT performance. Main outcomes were balance/mobility and cognitive function under both single-task (ST) and DT conditions.
Fifteen RCTs were included, involving two types of intervention techniques: transcranial direct current stimulation (tDCS) (twelve RCTs) and repetitive transcranial magnetic stimulation (rTMS) (three RCTs); and four different population groups: healthy young adults, older adults, Parkinson's disease (PD), and stroke. For tDCS, under DT condition, significant improvement in speed was only observed in one PD and one stroke RCT, and stride time variability in one older adults RCT. Reduction in DTC in some gait parameters was demonstrated in one RCT. Only one RCT showed significant reduction in postural sway speed and area during standing under DT condition in young adults. For rTMS, significant improvements in fastest walking speed and time taken to Timed-up-and-go test under both ST and DT conditions were observed at follow-up in one PD RCT only. No significant effect on cognitive function in any RCT was observed.
Both tDCS and rTMS showed promising effects in improving DT walking and balance performance in different populations, however, due to the large heterogeneity of included studies and insufficient data, any firm conclusion cannot be drawn at present.
越来越多的研究探讨了使用非侵入性脑刺激(NIBS)来增强双任务(DT)表现。
研究NIBS对不同人群DT表现的影响。
在PubMed、Medline、Cochrane图书馆、科学网和护理及健康领域累积索引数据库中进行了广泛的电子数据库检索(从数据库建立至2022年11月20日),以识别研究NIBS对DT表现影响的随机对照试验(RCT)。主要结局是单任务(ST)和DT条件下的平衡/移动能力以及认知功能。
纳入了15项RCT,涉及两种干预技术:经颅直流电刺激(tDCS)(12项RCT)和重复经颅磁刺激(rTMS)(3项RCT);以及四个不同人群组:健康年轻人、老年人、帕金森病(PD)患者和中风患者。对于tDCS,在DT条件下,仅在一项PD和一项中风RCT中观察到速度有显著改善,在一项老年人RCT中观察到步幅时间变异性有改善。一项RCT显示某些步态参数的双任务成本有所降低。仅一项RCT显示在DT条件下年轻人站立时姿势摆动速度和面积显著降低。对于rTMS,仅在一项PD RCT的随访中观察到在ST和DT条件下最快步行速度和计时起立行走测试所用时间有显著改善。在任何RCT中均未观察到对认知功能有显著影响。
tDCS和rTMS在改善不同人群的DT行走和平衡表现方面均显示出有前景的效果,然而,由于纳入研究的异质性大且数据不足,目前无法得出任何确凿结论。