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经颅直流电刺激对优势半球颞叶前部和背外侧前额叶的作用:轻度认知障碍患者的临床结果。

Anodal HD-tDCS on the dominant anterior temporal lobe and dorsolateral prefrontal cortex: clinical results in patients with mild cognitive impairment.

机构信息

Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

Medical Technology Research Center, Institute of Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Alzheimers Res Ther. 2024 Feb 3;16(1):27. doi: 10.1186/s13195-023-01370-y.

Abstract

OBJECTIVES

Mild cognitive impairment (MCI) is a neurocognitive disorder in which the cognitive and mental abilities of humans are declined. Transcranial direct-current stimulation (tDCS) is an emerging noninvasive brain stimulation technique aimed at neuromodulation. In this study, we investigate whether high-definition anodal tDCS stimulation (anodal HD-tDCS) in MCI patients in two different brain regions will be effective in improving cognitive function.

METHODS

This study was done as a randomized, double-blind clinical trial. Sixty MCI patients (clinically diagnosed by expert neurologists) were randomly divided into three groups. Two groups received 2-mA anodal HD-tDCS for 20 min for 2 weeks (5 consecutive days in each week, 10 days in total). In the first group (twenty patients), the left dorsolateral prefrontal cortex (left DLPFC) was targeted. In the second group (twenty patients), the target zone was the dominant anterior temporal lobe (DATL). The third group (twenty patients) formed the Sham group. The Montreal Cognitive Assessment (MoCA) and Quality of Life in Alzheimer's Disease (QoLAD) were considered as the outcome measures.

RESULTS

MCI patients obtained the highest MoCA mean scores in both left DLPFC and DATL groups versus the study baseline 2 weeks after the intervention. In addition, the MoCA mean scores of MCI patients were greater in both intervention groups compared to the Sham group up to 3 months post-stimulation (p-value ≤ 0.05). However, as we moved away from the first stimulation day, a decreasing trend in the MoCA mean scores was observed. Moreover, in the left DLPFC and DATL groups, higher QoLAD mean scores were observed 3-month post-stimulation, highlighting the effectiveness of anodal HD-tDCS in improving the quality of life in MCI patients.

CONCLUSION

In this research, it was shown that applying anodal HD-tDCS at left DLPFC and DATL brain regains for two successive weeks improves cognitive function in MCI patients (by obtaining higher values of MoCA scores) up to 3 months after the intervention compared to the Sham group. This illustrates the positive effects of HD-tDCS, as a non-pharmacological intervention, for improving cognitive function and quality of life in MCI patients.

SIGNIFICANCE

Two weeks after anodal HD-tDCS of the DLPFC and DATL brain regions, the MCI patients achieved the highest MoCA mean scores compared to the Sham group across all measurement intervals.

摘要

目的

轻度认知障碍(MCI)是一种神经认知障碍,人类的认知和心理能力下降。经颅直流电刺激(tDCS)是一种新兴的非侵入性脑刺激技术,旨在实现神经调节。在这项研究中,我们研究了在两个不同的脑区对 MCI 患者进行高分辨率阳极 tDCS 刺激(阳极 HD-tDCS)是否会有效改善认知功能。

方法

这是一项随机、双盲临床试验。60 名 MCI 患者(由专家神经病学家临床诊断)随机分为三组。两组患者接受 2 mA 阳极 HD-tDCS 刺激 20 分钟,持续 2 周(每周连续 5 天,共 10 天)。第一组(20 名患者)的目标区域是左侧背外侧前额叶皮层(左侧 DLPFC)。第二组(20 名患者)的目标区域是优势前颞叶(DATL)。第三组(20 名患者)为假刺激组。蒙特利尔认知评估(MoCA)和阿尔茨海默病患者生活质量(QoLAD)被认为是结果测量指标。

结果

与干预前相比,MCI 患者在接受干预后 2 周内左侧 DLPFC 和 DATL 两组的 MoCA 平均得分最高。此外,与假刺激组相比,在刺激后 3 个月时,干预组的 MCI 患者的 MoCA 平均得分更高(p 值≤0.05)。然而,随着我们远离第一次刺激日,MoCA 平均得分呈下降趋势。此外,在左侧 DLPFC 和 DATL 两组中,在刺激后 3 个月时观察到更高的 QoLAD 平均得分,突出了阳极 HD-tDCS 改善 MCI 患者生活质量的有效性。

结论

在这项研究中,我们表明,在两个连续的星期内对左侧 DLPFC 和 DATL 脑区进行阳极 HD-tDCS 刺激,可以提高 MCI 患者的认知功能(通过获得更高的 MoCA 分数),与假刺激组相比,在干预后 3 个月时的效果更加显著。这表明 HD-tDCS 作为一种非药物干预措施,对改善 MCI 患者的认知功能和生活质量具有积极作用。

意义

与所有测量间隔相比,阳极 HD-tDCS 刺激 DLPFC 和 DATL 脑区两周后,MCI 患者的 MoCA 平均得分最高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2198/10837991/2d51203c0031/13195_2023_1370_Fig1_HTML.jpg

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