DOPAMINE-INDEPENDENT EFFECTS OF COMBINING TRANSCRANIAL DIRECT CURRENT STIMULATION WITH CUED GAIT TRAINING ON CORTICAL EXCITABILITY AND FUNCTIONAL MOBILITY IN PARKINSON'S DISEASE
DOPAMINE-INDEPENDENT EFFECTS OF COMBINING TRANSCRANIAL DIRECT CURRENT STIMULATION WITH CUED GAIT TRAINING ON CORTICAL EXCITABILITY AND FUNCTIONAL MOBILITY IN PARKINSON'S DISEASE
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DOI：
10.2340/16501977-2134
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发表时间：
2016-10-01
影响因子：
3.5
通讯作者：
Monte-Silva, Katia
中科院分区：
文献类型：
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作者：
Costa-Ribeiro, Adriana;Maux, Ariadne;Monte-Silva, Katia
目的：探讨经颅直流电刺激 (tDCS) 与视觉提示步态训练相结合对帕金森病患者皮层兴奋性和功能活动性的多巴胺依赖性影响。设计：一项试点、随机、双盲、对照试验。方法：22 名帕金森病患者被随机分为 2 组：(1) 辅助运动区主动阳极 tDCS（实验组），或 (ii) 假 tDCS（对照组）。经颅直流电刺激后，两组均参加了视觉提示步态训练。通过计时起行测试 (TUG) 评估功能活动能力。通过主动运动阈值和经颅磁刺激引起的运动诱发电位振幅来评估患者在用药和停药状态下的皮层兴奋性。结果：在 TUG 测试中，与基线相比，两组在用药或停药状态下均取得了改善。然而，对于这两种药物治疗条件，与基线相比，这些收益仅在实验组中在 1 个月的随访期间得以维持。在实验组中，与基线相比，在干预后和 1 个月随访（均仅针对“开启”阶段）观察到皮质兴奋性增强。结论：这些研究结果表明，独立于多巴胺能药物状态的 tDCS 可能会延长提示步态训练对功能活动能力产生的积极作用。
Objective: To investigate the dopamine-dependent effect of combining transcranial direct current stimulation (tDCS) with visually cued gait training on cortical excitability and functional mobility in individuals with Parkinson's disease.Design: A pilot, randomized, double-blind, controlled trial.Methods: Twenty-two patients with Parkinson's disease were randomly assigned to 2 groups: (1) active anodal tDCS over the supplementary motor area (experimental group), or (ii) sham tDCS (control group). After tDCS, both groups participated in a visually cued gait training. Functional mobility was evaluated with the Timed Up and Go test (TUG). Cortical excitability was assessed by active motor threshold and motor-evoked potential amplitudes elicited by transcranial magnetic stimulation in patients in on and off medication states.Results: In the TUG test both groups achieved improvements either in on or off medication condition compared with baseline. However, for both medication conditions, these gains were maintained only in the experimental group during 1-month follow-up, compared with baseline. In the experimental group, enhancement of cortical excitability was observed at post-intervention and 1-month follow-up (both only for the "on" phase) compared with baseline.Conclusion: These findings suggest that tDCS, independent of dopaminergic medication state, might prolong the positive effect induced by cued gait training on functional mobility.