Transcranial direct current stimulation for the treatment of focal hand dystonia.

Transcranial direct current stimulation for the treatment of focal hand dystonia.
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DOI:
10.1002/mds.23691
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发表时间:
2011-08-01
期刊:
影响因子:
8.6
通讯作者:
Hallett, Mark
Hallett, Mark
中科院分区:
医学1区
文献类型:
--
作者:
Benninger, David H.;Lomarev, Mikhail;Lopez, Grisel;Pal, Natassja;Luckenbaugh, David A.;Hallett, Mark

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书写痉挛是一种任务特异性局灶性手肌张力障碍,其治疗需要新的方法。运动皮层的抑制功能不足可能会导致书写痉挛。经颅直流电刺激调节皮质兴奋性,并可能提供一种治疗选择。在这项随机、双盲、假手术对照研究中,我们研究了一周内3次阴极刺激对侧运动皮层的疗效。两周内的评估包括临床量表、主观评分、运动学笔迹分析和神经生理学评估。对12例单侧张力障碍性书写痉挛患者进行了研究,其中6例接受了经颅直流电刺激,6例接受了假刺激。阴极经颅直流电刺激在临床量表上没有良好的效果,并且未能恢复正常的笔迹运动学和皮层抑制。主观恶化仍无法解释,导致研究提前终止。对运动皮层进行阴极经颅直流电刺激的重复治疗没有产生支持书写痉挛治疗潜力的有利结果。
The treatment of Writer’s Cramp, a task-specific focal hand dystonia, needs new approaches. A deficiency of inhibition in the motor cortex might cause Writer’s Cramp. Transcranial direct current stimulation modulates cortical excitability and may provide a therapeutic alternative. In this randomized, double-blind, sham-controlled study, we investigated efficacy of cathodal stimulation of contralateral motor cortex in 3-sessions within one week. Assessment over a 2-week period included clinical scales, subjective ratings, kinematic handwriting analysis and neurophysiological evaluation. Twelve patients with unilateral dystonic Writer’s Cramp were investigated, 6 received transcranial direct current and 6 sham-stimulation. Cathodal transcranial direct current stimulation had no favorable effects on clinical scales, and failed to restore normal handwriting kinematics and cortical inhibition. Subjective worsening remained unexplained leading to premature study termination. Repeated sessions of cathodal transcranial direct current stimulation of the motor cortex yielded no favorable results supporting a therapeutic potential in Writer’s Cramp.
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