Department of Neurorehabilitation Laboratory, Graduate School of Health Sciences, Kio University, 4-2-2 Umaminaka, Koryo, Kitakatsuragi-gun, Nara, 635-0832, Japan.
Department of Therapy, Takarazuka Rehabilitation Hospital, Medical Corporation SHOWAKAI, 22-2 Tsurunoso, Takarazuka-shi, Hyogo, 665-0833, Japan.
Cerebellum. 2024 Dec;23(6):2638-2645. doi: 10.1007/s12311-024-01719-5. Epub 2024 Jul 25.
Damage to the cerebellum results in dysfunctional standing postural control. Patients with cerebellar ataxia have a larger sway in the center of gravity (COG) while standing. Transcranial direct current stimulation (tDCS) has been applied in the rehabilitation of patients with central nervous system disorders; however, its effect on COG sway in patients with cerebellar ataxia remains unknown. We aimed to confirm the effects of anodal cerebellar tDCS (ctDCS) combined with physical therapy on COG sway in a patient with cerebellar ataxia using a retrospective ABA single-case study design. This study involved a patient with left cerebellar hemorrhage. Walking and postural balance rehabilitation were conducted in phase A. Anodal ctDCS was combined with the walking and postural balance rehabilitation in phase B. We measured COG sway in the open- and closed-eyes standing conditions daily throughout all the phases. In the open-eyes standing condition, there was no significant change in COG sway in phase B. Conversely, in the closed-eyes standing condition, the circumferential area, total sway path length, and anteroposterior sway path length decreased in phase B. No change was observed in the mediolateral sway path length. The combination of anodal ctDCS and physical therapy may decrease COG sway in patients with cerebellar ataxia in the closed-eyes standing condition, and its effect may be greater in the anteroposterior direction.
小脑损伤会导致站立姿势控制功能障碍。小脑性共济失调患者在站立时重心（COG）摆动幅度更大。经颅直流电刺激（tDCS）已应用于中枢神经系统疾病患者的康复治疗中，但它对小脑性共济失调患者 COG 摆动的影响尚不清楚。我们旨在通过回顾性 ABA 单病例研究设计，确认小脑阳极 tDCS（ctDCS）联合物理疗法对小脑性共济失调患者 COG 摆动的影响。该研究涉及一名左侧小脑出血患者。在 A 阶段进行行走和姿势平衡康复。在 B 阶段，将阳极 ctDCS 与行走和姿势平衡康复相结合。我们在所有阶段的睁眼和闭眼站立条件下每天测量 COG 摆动。在睁眼站立条件下，B 阶段 COG 摆动无明显变化。相反，在闭眼站立条件下，B 阶段 COG 摆动的周向面积、总摆动路径长度和前后向摆动路径长度减小，而左右向摆动路径长度无变化。小脑性共济失调患者闭眼站立时，阳极 ctDCS 联合物理疗法可能会降低 COG 摆动，其在前后方向的效果可能更大。
