单次小脑经颅直流电刺激改善脊髓小脑共济失调的姿势稳定性和减少共济失调症状。

Single-Session Cerebellar Transcranial Direct Current Stimulation Improves Postural Stability and Reduces Ataxia Symptoms in Spinocerebellar Ataxia.

机构信息

Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Jornalista Aníbal Fernandes Avenue, Recife, 50740-560, PE, Brasil.

NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Palmares, Pernambuco, Brazil.

出版信息

Cerebellum. 2024 Oct;23(5):1993-2002. doi: 10.1007/s12311-024-01696-9. Epub 2024 May 2.

Abstract

Spinocerebellar ataxia (SCA) results in balance and coordination impairment, and current treatments have limited efficacy. Recent evidence suggests that combining postural training with cerebellar transcranial direct current stimulation (ctDCS) can improve these symptoms. However, the combined effects of ctDCS and postural training on individuals with spinocerebellar ataxia remain underexplored. Ten volunteers with (SCA type 3) participated in a triple-blind, randomized, crossover study to receive a single session of ctDCS (2 mA for 20 min) and a sham ctDCS session separated by at least one week. The Biodex Balance System was used to assess balance at each session, measuring overall stability index, anteroposterior stability index, and medial-lateral stability index. As secondary outcomes, cerebellar ataxia symptoms were evaluated using the 8-item Scale for Assessment and Rating of Ataxia. The assessments were conducted before and after each session. The results indicated that ctDCS enhanced the overall stability index when compared to sham ctDCS (Z = -2.10, p = 0.03), although it did not significantly affect the anteroposterior or medial-lateral stability indices. Compared to the baseline, a single session of ctDCS reduced appendicular symptoms related to cerebellar ataxia, as evidenced by improvements in the nose-finger test (Z = -2.07, p = 0.04), fast alternating hand movements (Z = -2.15, p = 0.03), and heel-to-shin slide (Z = -1.91, p = 0.05). In conclusion, our study suggests that a single session of ctDCS, in combination with postural training, can enhance balance and alleviate ataxia symptoms in individuals with cerebellar ataxia. This study was approved by the local research ethics committee (No. 2.877.813) and registered on clinicaltrials.org (NCT04039048 - https://www.clinicaltrials.gov/study/NCT04039048 ) on 2019-07-28.

摘要

脊髓小脑共济失调(SCA)导致平衡和协调受损,目前的治疗方法疗效有限。最近的证据表明,将姿势训练与小脑经颅直流电刺激(ctDCS)相结合可以改善这些症状。然而,ctDCS 和姿势训练对脊髓小脑共济失调患者的联合影响仍未得到充分探索。10 名(SCA 型 3)志愿者参与了一项三盲、随机、交叉研究,以接受单次 ctDCS(2 mA 持续 20 分钟)和 sham ctDCS 治疗,两次治疗间隔至少一周。使用 Biodex 平衡系统在每次治疗时评估平衡,测量总体稳定性指数、前后稳定性指数和内外稳定性指数。作为次要结果,使用 8 项共济失调评估和评分量表评估小脑共济失调症状。在每次治疗前后进行评估。结果表明,与 sham ctDCS 相比,ctDCS 增强了总体稳定性指数(Z = -2.10,p = 0.03),尽管它对前后或内外稳定性指数没有显著影响。与基线相比,单次 ctDCS 可减少与小脑共济失调相关的四肢症状,表现在鼻指试验(Z = -2.07,p = 0.04)、快速交替手运动(Z = -2.15,p = 0.03)和足跟至小腿滑动(Z = -1.91,p = 0.05)改善。总之,我们的研究表明,单次 ctDCS 联合姿势训练可增强小脑共济失调患者的平衡能力并减轻共济失调症状。本研究得到了当地伦理委员会的批准(编号 2.877.813),并在 clinicaltrials.org 上注册(NCT04039048-https://www.clinicaltrials.gov/study/NCT04039048),于 2019 年 7 月 28 日。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索