脑深部电刺激中的患者选择：经颅直流电刺激在增强左旋多巴激发试验中的作用？
Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?
作者信息
Goede Lukas L, Zvarova Patricia, Bahners Bahne H, Horn Andreas
机构信息
Center for Brain Circuit Therapeutics, Departments of Neurology, Psychiatry, and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Neurology With Experimental Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
出版信息
Ann Clin Transl Neurol. 2025 May 19;12(8):1698-701. doi: 10.1002/acn3.70073.
Dopaminergic medication and deep brain stimulation (DBS) improve motor symptoms in Parkinson's disease (PD), but levodopa response alone may not predict DBS outcomes. We retrospectively analyzed 19 PD patients undergoing levodopa challenges with and without prior transcranial direct current stimulation targeting a defined PD response network. Levodopa improved motor performance more after tDCS than sham (41.72% vs. 31.52%; p < 0.001). In ten patients who later received DBS, the combined levodopa-tDCS response accounted for DBS outcomes (p = 0.02). These findings suggest that targeted tDCS enhances levodopa effects and may be of potential use to optimize DBS candidate selection.
多巴胺能药物和深部脑刺激（DBS）可改善帕金森病（PD）的运动症状，但仅左旋多巴反应可能无法预测DBS的效果。我们回顾性分析了19例接受左旋多巴激发试验的PD患者，其中部分患者在进行试验前接受了针对特定PD反应网络的经颅直流电刺激（tDCS），部分未接受。与假刺激相比，tDCS后左旋多巴对运动表现的改善更明显（41.72% 对 31.52%；p < 0.001）。在随后接受DBS的10例患者中，左旋多巴-tDCS联合反应可预测DBS效果（p = 0.02）。这些发现表明，靶向tDCS可增强左旋多巴的作用，可能有助于优化DBS候选者的选择。
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