Tremor suppression by rhythmic transcranial current stimulation.

Tremor suppression by rhythmic transcranial current stimulation.
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DOI:
10.1016/j.cub.2013.01.068
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发表时间:
2013-03-04
期刊:
影响因子:
9.2
通讯作者:
Brown, Peter
Brown, Peter
中科院分区:
生物学1区
文献类型:
--
作者:
Brittain, John-Stuart;Probert-Smith, Penny;Aziz, Tipu Z.;Brown, Peter

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震颤可以支配帕金森氏病,但对多巴胺能药物的反应不如这种疾病的其他主要症状。深部脑刺激可以显著缓解震颤,但将刺激电极引入大脑深处会带来重大风险,包括出血风险。在这里,我们开创了一种替代方法,即非侵入性地对运动皮质施加经颅交流电刺激(TACS),以诱导静息震颤节律的相位取消。我们首先通过在运动皮层上提供震颤频率刺激来确定皮层振荡的时间,而不是将这种刺激与正在进行的震颤相耦合,相反,节奏只是“漂移”在彼此的相位对准和相位对准之外。相位取消和强化的缓慢交替周期的结果,通知相位对齐,引起震颤幅度的最大变化。接下来,我们在这些指定的相位对准处提供刺激,以证明对正在进行的震颤的受控抑制。通过这种技术,我们可以实现静息震颤幅度平均降低近50%,这样做形成了闭环震颤抑制治疗的基础,可以扩展到其他震颤病。相位取消皮层刺激减弱帕金森震颤延长刺激可能会引发适应机制相位取消可能会为帕金森病提供一种通用的治疗方法TACS提供了一种方便的人类皮层回路动力学探针
Tremor can dominate Parkinson’s disease and yet responds less well to dopaminergic medications than do other cardinal symptoms of this condition. Deep brain stimulation can provide striking tremor relief, but the introduction of stimulating electrodes deep in the substance of the brain carries significant risks, including those of hemorrhage. Here, we pioneer an alternative approach in which we noninvasively apply transcranial alternating current stimulation (TACS) over the motor cortex to induce phase cancellation of the rest tremor rhythm. We first identify the timing of cortical oscillations responsible for rest tremor in the periphery by delivering tremor-frequency stimulation over motor cortex but do not couple this stimulation to the on-going tremor—instead, the rhythms simply “drift” in and out of phase alignment with one another. Slow alternating periods of phase cancellation and reinforcement result, informing on the phase alignments that induce the greatest change in tremor amplitude. Next, we deliver stimulation at these specified phase alignments to demonstrate controlled suppression of the on-going tremor. With this technique we can achieve almost 50% average reduction in resting tremor amplitude and in so doing form the basis of a closed-loop tremor-suppression therapy that could be extended to other oscillopathies. ► Phase-cancelling cortical stimulation attenuates Parkinsonian tremor ► Prolonged stimulation may invoke adaptive mechanisms ► Phase cancellation may provide a generic treatment approach to oscillopathies ► TACS provides a convenient probe of cortical circuit dynamics in humans
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