Multitarget Transcranial Electrical Stimulation for Freezing of Gait: A Randomized Controlled Trial
Multitarget Transcranial Electrical Stimulation for Freezing of Gait: A Randomized Controlled Trial
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多靶点经颅电刺激治疗步态冻结的随机对照研究
DOI：
10.1002/mds.28759
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发表时间：
2021-08-18
影响因子：
8.6
通讯作者：
Hausdorff, Jeffrey M.
中科院分区：
文献类型：
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作者：
Manor, Brad;Dagan, Moria;Hausdorff, Jeffrey M.
背景帕金森氏病的步态冻结（FOG）治疗效果欠佳。目的探讨多次经颅直流电刺激（tDCS）左前额叶背外侧皮层和初级运动皮层（M1）对FOG的影响。方法77例帕金森病合并FOG患者参加双盲随机试验。tDCS和假干预包括2周内的10次会议，随后是每周一次的5次会议。评估FOG激发测试表现（主要结局）、功能结局和自我报告的FOG严重程度。结果初步分析表明，在FOG激发试验中，tDCS没有优势。在次要分析中，与假手术相比，tDCS降低了自我报告的FOG严重程度，增加了日常生活步数。在轻度至中度FOG严重程度的个体中，tDCS改善了FOG激发测试时间和FOG的自我报告。结论：针对左侧背外侧前额叶皮层和M1的多阶段tDCS并没有改善基于实验室的FOG激发测试的表现。在轻度至中度FOG严重程度的参与者中观察到的改善值得进一步研究。(c)2021国际帕金森和运动障碍协会
Background Treatments of freezing of gait (FOG) in Parkinson's disease are suboptimal. Objective The aim of this study was to evaluate the effects of multiple sessions of transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex and primary motor cortex (M1) on FOG. Methods Seventy-seven individuals with Parkinson's disease and FOG were enrolled in a double-blinded randomized trial. tDCS and sham interventions comprised 10 sessions over 2 weeks followed by five once-weekly sessions. FOG-provoking test performance (primary outcome), functional outcomes, and self-reported FOG severity were assessed. Results Primary analyses demonstrated no advantage for tDCS in the FOG-provoking test. In secondary analyses, tDCS, compared with sham, decreased self-reported FOG severity and increased daily living step counts. Among individuals with mild-to-moderate FOG severity, tDCS improved FOG-provoking test time and self-report of FOG. Conclusions Multisession tDCS targeting the left dorsolateral prefrontal cortex and M1 did not improve laboratory-based FOG-provoking test performance. Improvements observed in participants with mild-to-moderate FOG severity warrant further investigation. (c) 2021 International Parkinson and Movement Disorder Society