Generalizing remotely supervised transcranial direct current stimulation (tDCS): feasibility and benefit in Parkinson's disease
Generalizing remotely supervised transcranial direct current stimulation (tDCS): feasibility and benefit in Parkinson's disease
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DOI：
10.1186/s12984-018-0457-9
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发表时间：
2018-12-07
影响因子：
5.1
通讯作者：
Charvet, Leigh
中科院分区：
文献类型：
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作者：
Dobbs, Bryan;Pawlak, Natalie;Charvet, Leigh
背景经颅直流电刺激（tDCS）是一种非侵入性脑刺激技术，已被证明可以改善神经系统疾病的常见症状，如情绪低落、疲劳、运动缺陷和认知功能障碍。 tDCS 需要每天进行治疗才能有效。我们为多发性硬化症 (MS) 参与者开发了远程监督的 tDCS (RS-tDCS) 协议，以提高 tDCS 的可及性，减少临床医生、患者和护理人员的负担。该方案的目标是促进家庭使用以延长治疗期的大型试验。在本研究中，我们通过测试 RS-tDCS 与认知训练 (CT) 配对在帕金森病 (PD) 参与者中的可行性，确定其普遍性。方法按照我们 MS 方案开发中的方法，我们招募了 16 名患有 PD 的参与者（n=12 名男性，n=4 名女性；平均年龄 66 岁），在家中在经过培训的远程监督下完成 10 次 RS-tDCS 与 CT 配对的开放标签疗程（2.0mAx20 分钟）。研究技术员。在每次单独治疗之前、期间和之后收集耐受性数据。基线和随访措施包括症状清单（疲劳和睡眠）和认知评估。结果RS-tDCS 对于 PD 患者来说是可行且可耐受的，在家使用可实现较高的方案依从性。副作用主要限于电极部位下方短暂瘙痒和烧灼感的轻微感觉。与之前发现的罪 MS 类似，我们发现了改善 PD 疲劳和认知处理速度的初步功效。结论 RS-tDCS 与 CT 配对对于 PD 参与者在家接受治疗是可行的。在 PD 和 MS 样本中，减少疲劳和提高认知处理速度的益处信号是一致的。 RS-tDCS 可以推广到为一系列神经系统疾病患者提供 tDCS 进行家庭康复。试验注册ClinicalTrials.gov 标识符：NCT02746705。 2016年4月21日注册。
BackgroundTranscranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has been shown to improve common symptoms of neurological disorders like depressed mood, fatigue, motor deficits and cognitive dysfunction. tDCS requires daily treatment sessions in order to be effective. We developed a remotely supervised tDCS (RS-tDCS) protocol for participants with multiple sclerosis (MS) to increase accessibility of tDCS, reducing clinician, patient, and caregiver burden. The goal of this protocol is to facilitate home use for larger trials with extended treatment periods. In this study we determine the generalizability of RS-tDCS paired with cognitive training (CT) by testing its feasibility in participants with Parkinson's disease (PD).MethodsFollowing the methods in our MS protocol development, we enrolled sixteen participants (n=12 male, n=4 female; mean age 66years) with PD to complete ten open-label sessions of RS-tDCS paired with CT (2.0mAx20min) at home under the remote supervision of a trained study technician. Tolerability data were collected before, during, and after each individual session. Baseline and follow-up measures included symptom inventories (fatigue and sleep) and cognitive assessments.ResultsRS-tDCS was feasible and tolerable for patients with PD, with at-home access leading to high protocol compliance. Side effects were mostly limited to mild sensations of transient itching and burning under the electrode sites. Similar to prior finding sin MS, we found preliminary efficacy for improvement of fatigue and cognitive processing speed in PD.ConclusionsRS-tDCS paired with CT is feasible for participants with PD to receive at home treatment. Signals of benefit for reduced fatigue and improved cognitive processing speed are consistent across the PD and MS samples. RS-tDCS can be generalized to provide tDCS to a range of patients with neurologic disorders for at-home rehabilitation.Trial registrationClinicalTrials.gov Identifier: NCT02746705. Registered April 21st 2016.