Assessment of tDCS-Induced Neuronal Responses with Advanced MRI

项目总结/摘要 经颅直流电刺激（tDCS）是一种安全、耐受性好且成本低的治疗方法， 在控制症状和促进患者康复方面显示出有效的治疗效果， 多发性硬化症（MS）。尽管有积极的临床研究结果，但tDCS的潜在机制在很大程度上仍然是未知的。 不清楚目前，关于外部应用tDCS如何以及是否改变神经功能的知识存在空白。 MS中的活性和氧代谢，以及如何以及是否减轻了由于tDCS引起的MS症状 与神经元代谢变化相关。拟议的项目将使用先进的MRI技术来测试 即刻（通过同步MRI）、累积（在30次tDCS治疗结束时）和延迟（3 治疗后6个月）tDCS对神经元代谢的影响（例如，脑氧代谢率或 CMRO2）在继发性进展性MS（SPMS）患者中的作用。此外，tDCS可以用作已知的挑战。 使用MRI作为检查大脑的生理动作，增加CMRO2测量的神经活动 储备或可塑性，通过它我们将开发神经元反应性（NR）的生物标志物（即，百分 CMRO 2的增加）。此外，我们将关联的tDCS调制 通过静息状态功能性MRI和临床改善测量脑网络连接。具体 该项目的目的是1）比较假手术、同时tDCS期间和术后即刻的CMRO2水平 在基线MR和SPMS患者30次家庭tDCS治疗结束时进行刺激; 2） 确定基线和30次家庭tDCS治疗后的脑网络连接变化 调节; 3）评估基线NR（即，CMRO增加百分比2），CMNR （从基线到30次家庭治疗的变化）、连接测量和行为结果测量 在每次MRI访视和tDCS治疗后3个月评估疲劳和神经认知功能。等 信息对于提供tDCS调节的客观和直接的神经元生物生理学证据是至关重要的， 具有指导和解释tDCS干预如何减缓或预防疾病的强大潜力 这些患者的病情进展。

Project Summary/Abstract Transcranial direct current stimulation (tDCS) is a safe, well-tolerated and low-cost treatment approach and has shown effective therapeutic effects in managing symptoms and to enhancing recovery in patients with multiple sclerosis (MS). Despite positive clinical findings, the underlying mechanism of tDCS remains largely unclear. There is a current gap of knowledge of how and whether externally-applied tDCS modifies neural activity and oxygen metabolism in MS, as well as how and whether alleviated symptoms of MS due to tDCS correlate with neuronal metabolic changes. The proposed project will use advanced MRI techniques to test immediate (by simultaneous MRI), cumulative (at the end of 30 tDCS treatment sessions), and lingering (3 months after treatment) effects of tDCS on neuronal metabolism (e.g., cerebral metabolic rate of oxygen or CMRO2) in patients with secondary progressive MS (SPMS). Further, tDCS can be used as a challenge known to increase neural activity measured with CMRO2 using MRI as a physiological maneuver to examine the brain reserves or plasticity, through which we will develop biomarker of neuronal reactivity (NR) (i.e., percent increase of CMRO2) induced by the current stimulation. Additionally, we will correlate the tDCS modulation of brain network connectivity measured with resting state functional MRI and clinical improvement. The specific aims of the project are 1) To compare CMRO2 levels during sham, simultaneous tDCS and immediately after stimulation on baseline MR and at the end of 30 home-based tDCS sessions in patients with SPMS; 2) To determine the brain network connectivity changes between baseline and after 30 sessions home-based tDCS modulation; 3) To assess the relationship between the baseline NR (i.e., percent increase of CMRO2), ∆NR (change from baseline to 30 home-based sessions), connectivity measures, and behavioral outcome measures (fatigue and neurocognitive function) assessed at each MRI visit and 3 months after tDCS treatment. Such information is critical in providing objective and direct neuronal biophysiological evidence of tDCS modulation, with a strong potential to guide and interpret how tDCS interventions can slow down or prevent disease progression in these patients.