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经颅直流电刺激(tDCS)作用于额极区的神经康复神经机制

Neural Mechanisms of Neuro-Rehabilitation Using Transcranial Direct Current Stimulation (tDCS) over the Front-Polar Area.

作者信息

Ishikuro Koji, Hattori Noriaki, Otomune Hironori, Furuya Kohta, Nakada Takeshi, Miyahara Kenichiro, Shibata Takashi, Noguchi Kyo, Kuroda Satoshi, Nakatsuji Yuji, Nishijo Hisao

机构信息

Department of Rehabilitation, Toyama University Hospital, Toyama 930-0194, Japan.

Department of Physical Therapy, Toyama College of Medical Welfare, Toyama 930-0194, Japan.

出版信息

Brain Sci. 2023 Nov 18;13(11):1604. doi: 10.3390/brainsci13111604.

Abstract

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation (NIBS) technique that applies a weak current to the scalp to modulate neuronal excitability by stimulating the cerebral cortex. The technique can produce either somatic depolarization (anodal stimulation) or somatic hyperpolarization (cathodal stimulation), based on the polarity of the current used by noninvasively stimulating the cerebral cortex with a weak current from the scalp, making it a NIBS technique that can modulate neuronal excitability. Thus, tDCS has emerged as a hopeful clinical neuro-rehabilitation treatment strategy. This method has a broad range of potential uses in rehabilitation medicine for neurodegenerative diseases, including Parkinson's disease (PD). The present paper reviews the efficacy of tDCS over the front-polar area (FPA) in healthy subjects, as well as patients with PD, where tDCS is mainly applied to the primary motor cortex (M1 area). Multiple evidence lines indicate that the FPA plays a part in motor learning. Furthermore, recent studies have reported that tDCS applied over the FPA can improve motor functions in both healthy adults and PD patients. We argue that the application of tDCS to the FPA promotes motor skill learning through its effects on the M1 area and midbrain dopamine neurons. Additionally, we will review other unique outcomes of tDCS over the FPA, such as effects on persistence and motivation, and discuss their underlying neural mechanisms. These findings support the claim that the FPA could emerge as a new key brain region for tDCS in neuro-rehabilitation.

摘要

经颅直流电刺激(tDCS)是一种非侵入性脑刺激(NIBS)技术,它通过向头皮施加微弱电流来刺激大脑皮层,从而调节神经元兴奋性。基于通过从头皮施加微弱电流非侵入性刺激大脑皮层所使用电流的极性,该技术可以产生体细胞去极化(阳极刺激)或体细胞超极化(阴极刺激),使其成为一种能够调节神经元兴奋性的NIBS技术。因此,tDCS已成为一种有前景的临床神经康复治疗策略。这种方法在神经退行性疾病的康复医学中具有广泛的潜在用途,包括帕金森病(PD)。本文综述了tDCS作用于健康受试者以及PD患者额极区(FPA)的疗效,其中tDCS主要应用于初级运动皮层(M1区)。多条证据表明FPA在运动学习中发挥作用。此外,最近的研究报告称,作用于FPA的tDCS可以改善健康成年人和PD患者的运动功能。我们认为,将tDCS应用于FPA可通过其对M1区和中脑多巴胺神经元的作用来促进运动技能学习。此外,我们将综述tDCS作用于FPA的其他独特结果,如对持续性和动机的影响,并讨论其潜在的神经机制。这些发现支持了FPA可能成为tDCS在神经康复中新的关键脑区这一观点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfd5/10670271/8bb88bda0a5d/brainsci-13-01604-g001.jpg

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