Effect of Dual-Mode and Dual-Site Noninvasive Brain Stimulation on Freezing of Gait in Patients With Parkinson Disease
Effect of Dual-Mode and Dual-Site Noninvasive Brain Stimulation on Freezing of Gait in Patients With Parkinson Disease
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DOI：
10.1016/j.apmr.2017.01.011
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发表时间：
2017-07-01
影响因子：
4.3
通讯作者：
Kim, Yun-Hee
中科院分区：
文献类型：
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作者：
Chang, Won Hyuk;Kim, Min Soo;Kim, Yun-Hee
目的：探讨双模式无创脑刺激（NIBS）联合高频重复经颅磁刺激（rTMS）对下肢初级运动皮层和经颅直流电刺激（tDCS）对左背外侧前额叶皮层的影响，并与单纯经颅直流电刺激（tDCS）对帕金森病（PD）伴步态冻结（FOG）患者的影响进行比较。设计：随机、双盲、对照研究。环境：门诊康复诊所。参与者：诊断为PD合并FOG的患者（N=32）。干预措施：双模式组患者每天连续5次进行双模式NIBS，同时进行高频rTMS和tDCS，而rTMS组患者进行高频rTMS和假tDCS。主要结局指标：对FOG和运动、移动和认知功能进行3次评估：NIBS前基线、NIBS后立即和NIBS停止后1周。结果：两组均未见严重不良反应。随着时间的推移，各组的FOG、运动功能和移动功能均发生了显著变化；但两组间差异无统计学意义。仅在双模式组中，NIBS后执行功能有显著改善。结论：这些结果表明双模式NIBS可能同时调节两个不同的皮层。双模式NIBS可能被认为是PD患者的一种新的治疗方法。(C) 2017年美国康复医学大会
Objective: To investigate the effect of dual-mode noninvasive brain stimulation (NIBS) with high-frequency repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex of the lower leg and anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex compared with rTMS alone in patients with Parkinson disease (PD) with freezing of gait (FOG).Design: Randomized, double-blind, controlled study.Setting: Outpatient rehabilitation clinics.Participants: Patients diagnosed as having PD with FOG (N=32).Interventions: Patients in the dual-mode group underwent 5 consecutive daily sessions of dual-mode NIBS with high-frequency rTMS and tDCS simultaneously, whereas patients in the rTMS group underwent high-frequency rTMS and sham tDCS.Main Outcome Measures: Assessments of FOG and motor, ambulatory, and cognitive function were performed 3 times: at baseline before NIBS, immediately after NIBS, and 1 week after cessation of NIBS.Results: Serious adverse effects were not observed in either group. Significant changes over time were observed in FOG, motor function, and ambulatory function in each group; however, there was no significant difference between the 2 groups. Executive function showed significant improvement after NIBS only in the dual-mode group.Conclusions: These results suggest the potential for dual-mode NIBS to modulate 2 different cortices simultaneously. Dual-mode NIBS might be considered a novel therapeutic approach for patients with PD. (C) 2017 by the American Congress of Rehabilitation Medicine