Xu Qiaoqiao, Yin Wenwen, Zhou Xia, Wang Shuo, Chen Sishi, Yang Jiajia, Xi Chunhua, Sun Zhongwu
Department of Neurology, The Third Affiliated Hospital of Anhui Medical University (Hefei City First People's Hospital), Hefei, Anhui, China.
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Front Aging Neurosci. 2025 Jan 7;16:1511287. doi: 10.3389/fnagi.2024.1511287. eCollection 2024.
Cerebral small vessel disease (CSVD) is a chronic systemic degenerative disease affecting small blood vessels in the brain, leading to cognitive impairments. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique that applies low electrical currents to the scalp, shows promise in treating cognitive and movement disorders. However, further clinical evaluation is required to assess the long-term effects of tDCS on neuroplasticity and gait in patients with CSVD. We investigated the effects of long-term, repeated tDCS on local brain perfusion, network connectivity, cognition, and gait in patients with CSVD and gait disorders (CSVD-GD).
This prospective, single-blind, multicenter, randomized controlled study enrolled 66 patients with CSVD-GD, categorized into the tDCS and Sham groups. Imaging and gait characteristic data were collected over three periods using magnetic resonance imaging and a gait analyzer, along with neuropsychological assessments.
Among 156 volunteers with CSVD-GD, 66 participated in this study, with 60 completing the entire process. Compared to the Sham group, the tDCS group exhibited a more pronounced increase in the cerebral blood flow to the dural cerebrospinal fluid ratio in regions such as the orbitofrontal cortex and cingulate gyrus ( < 0.05, FDR corrected), along with significantly greater improvements in gait speed and stride length. Tolerance to tDCS was good, with no difference in adverse reactions between the groups, except for a scalp burning sensation reported during the 1st week (24.24% and 6.06% in the tDCS and Sham groups, respectively; = 0.003).
Long-term tDCS is effective and safe for improving neuroplasticity and gait cognition in patients with CSVD.
脑小血管病（CSVD）是一种慢性全身性退行性疾病，影响脑内小血管，导致认知障碍。经颅直流电刺激（tDCS）是一种非侵入性脑刺激技术，通过向头皮施加低电流，在治疗认知和运动障碍方面显示出前景。然而，需要进一步的临床评估来评估tDCS对CSVD患者神经可塑性和步态的长期影响。我们研究了长期、重复的tDCS对CSVD和步态障碍（CSVD-GD）患者局部脑灌注、网络连通性、认知和步态的影响。
这项前瞻性、单盲、多中心、随机对照研究纳入了66例CSVD-GD患者，分为tDCS组和假刺激组。使用磁共振成像和步态分析仪在三个时间段收集成像和步态特征数据，同时进行神经心理学评估。
在156例CSVD-GD志愿者中，66例参与了本研究，60例完成了整个过程。与假刺激组相比，tDCS组在眶额皮质和扣带回等区域的硬脑膜脑脊液比率的脑血流量增加更为明显（<0.05，FDR校正），同时步态速度和步幅的改善也显著更大。tDCS的耐受性良好，两组不良反应无差异，除了第1周报告的头皮烧灼感（tDCS组和假刺激组分别为24.24%和6.06%；P = 0.003）。
长期tDCS对改善CSVD患者的神经可塑性和步态认知是有效且安全的。
