经颅直流电刺激治疗帕金森病：运动和认知效应的系统评价与荟萃分析

Transcranial direct current stimulation for Parkinson's disease: systematic review and meta-analysis of motor and cognitive effects.

作者信息

Duan Zhuo, Zhang Chencheng

机构信息

Clinical Neuroscience Center, Ruijin Hospital Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Clinical Neuroscience Center, Department of Psychiatry & Mental Health, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

NPJ Parkinsons Dis. 2024 Nov 6;10(1):214. doi: 10.1038/s41531-024-00821-z.

Transcranial direct current stimulation (tDCS) is a promising noninvasive intervention for Parkinson's disease (PD). However, studies of its motor and cognitive effect have produced mixed results. We conducted a systematic review including 38 studies and meta-analysis of 12 randomized sham-controlled trials with 263 PD patients. No significant differences were found between active and sham tDCS in motor function (UPDRS-III: SMD = -0.14, p = 0.74), gait (SMD = 0.10, p = 0.513), attention and working memory (SMD = 0.24, p = 0.13), executive function (SMD = 0.03, p = 0.854), and memory and learning (SMD: -0.07, p = 0.758). The prediction intervals indicated substantial heterogeneity among studies. Meta-regression showed small positive effects in younger PD patients with milder symptoms. These findings are preliminary but suggest tDCS may benefit some PD patients while being neutral or harmful to others.

经颅直流电刺激（tDCS）是一种很有前景的用于治疗帕金森病（PD）的非侵入性干预方法。然而，关于其对运动和认知影响的研究结果不一。我们进行了一项系统综述，纳入了38项研究，并对12项随机假对照试验（涉及263名帕金森病患者）进行了荟萃分析。在运动功能（统一帕金森病评定量表第三部分：标准化均数差 = -0.14，p = 0.74）、步态（标准化均数差 = 0.10，p = 0.513）、注意力和工作记忆（标准化均数差 = 0.24，p = 0.13）、执行功能（标准化均数差 = 0.03，p = 0.854）以及记忆和学习（标准化均数差：-0.07，p = 0.758）方面，主动tDCS和假tDCS之间未发现显著差异。预测区间表明各研究之间存在实质性异质性。荟萃回归显示，症状较轻的年轻帕金森病患者有小的积极效应。这些发现是初步的，但表明经颅直流电刺激可能对一些帕金森病患者有益，而对另一些患者则是中性或有害的。