Muccio Marco, Pilloni Giuseppina, Walton Masters Lillian, He Peidong, Krupp Lauren, Datta Abhishek, Bikson Marom, Charvet Leigh, Ge Yulin
Department of Radiology, NYU Grossman School of Medicine, New York, NY, United States.
Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States.
Front Hum Neurosci. 2024 Jul 16;18:1418647. doi: 10.3389/fnhum.2024.1418647. eCollection 2024.
Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique with simultaneous (during stimulation) and cumulative effects (after repeated sessions) on blood flow and neuronal metabolism. These effects remain mostly unclear especially in multiple sclerosis (MS). This work aims to elucidate brain metabolic and hemodynamic underpinnings of tDCS and its potential therapeutic impact in MS patients using quantitative tDCS-MRI.
MS participants (n = 20; age = 45.4 ± 12.3 years, 7 males) underwent 3 T MRI scans before and after 20 daily sessions of dorsolateral prefrontal cortex (DLFPC) tDCS (2.0 mA, left anodal) paired with adaptive cognitive training (aCT). During both visits, imaging measurements of cerebral blood flow (CBF), cerebral venous blood oxygenation (Yv) and calculated cerebral metabolic rate of oxygen (CMRO) were obtained at pre-tDCS, during-tDCS and post-tDCS.
At baseline, significant increase from pre- to during-tDCS was observed in CMRO (7.6%; = 0.002), CBF (11.0%; < 0.0001) and Yv (1.9%; = 0.006). At follow up, we observed an increase in pre-tDCS CMRO (140.59 ± 13.83 μmol/100 g/min) compared to baseline pre-tDCS levels (128.30 ± 14.00 μmol/100 g/min; = 0.006). Sustained elevations in CMRO and CBF into post-tDCS were also observed (tDCS lingering effects). Cumulative tDCS effects were observed in the form of sustained elevations in CMRO and CBF in pre-tDCS follow up, reaching the magnitudes measured at baseline during-tDCS.
TDCS induces an acute surge in metabolic activity persisting immediately after the stimulation is removed. Moreover, treatment composed of repeated tDCS-aCT paired sessions contributes to establishing long-lasting increases in neuronal activity.
经颅直流电刺激（tDCS）是一种非侵入性神经调节技术，对血流和神经元代谢具有即时（刺激期间）和累积效应（重复疗程后）。这些效应在很大程度上仍不明确，尤其是在多发性硬化症（MS）患者中。本研究旨在利用定量tDCS-MRI阐明tDCS对MS患者的脑代谢和血流动力学基础及其潜在治疗作用。
MS患者（n = 20；年龄 = 45.4 ± 12.3岁，7名男性）在背外侧前额叶皮质（DLFPC）进行20次每日tDCS（2.0 mA，左侧阳极）并结合适应性认知训练（aCT）前后接受3T MRI扫描。在两次检查期间，分别在tDCS前、tDCS期间和tDCS后获取脑血流量（CBF）、脑静脉血氧饱和度（Yv）和计算得出的脑氧代谢率（CMRO）的成像测量值。
在基线时，tDCS期间CMRO显著升高（7.6%；P = 0.002）、CBF显著升高（11.0%；P < 0.0001）、Yv显著升高（1.9%；P = 0.006）。在随访时，与基线tDCS前水平（128.30 ± 14.00 μmol/100g/min；P = 0.006）相比，观察到tDCS前CMRO升高（140.59 ± 13.83 μmol/100g/min）。还观察到CMRO和CBF持续升高至tDCS后（tDCS的持续效应）。在tDCS前随访中观察到CMRO和CBF持续升高形式的累积tDCS效应，达到基线tDCS期间测量的幅度。
tDCS诱导代谢活动急性激增，在刺激停止后立即持续存在。此外，由重复的tDCS-aCT配对疗程组成的治疗有助于建立神经元活动的长期增加。
