Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease

作者：Felipe Fregni, Paulo S. Boggio, Marcelo Cabral Santos, Moises C. Lima, Adriana Lopes Vieira, Sergio P. Rigonatti, M. Teresa A. Silva, Egberto Reis Barbosa, Michael Andreas Nitsche, Álvaro Pascual‐Leone · 发表于：Movement Disorders · 年份：2006 · DOI：10.1002/mds.21012 · 被引用次数：442 · 研究领域：Transcranial Magnetic Stimulation Studies、Neurological disorders and treatments、Muscle activation and electromyography studies

Electrical stimulation of deep brain structures, such as globus pallidus and subthalamic nucleus, is widely accepted as a therapeutic tool for patients with Parkinson's disease (PD). Cortical stimulation either with epidural implanted electrodes or repetitive transcranial magnetic stimulation can be associated with motor function enhancement in PD. We aimed to study the effects of another noninvasive technique of cortical brain stimulation, transcranial direct current stimulation (tDCS), on motor function and motor-evoked potential (MEP) characteristics of PD patients. We tested tDCS using different electrode montages [anodal stimulation of primary motor cortex (M1), cathodal stimulation of M1, anodal stimulation of dorsolateral prefrontal cortex (DLPFC), and sham-stimulation] and evaluated the effects on motor function--as indexed by Unified Parkinson's Disease Rating Scale (UPDRS), simple reaction time (sRT) and Purdue Pegboard test--and on corticospinal motor excitability (MEP characteristics). All experiments were performed in a double-blinded manner. Anodal stimulation of M1 was associated with a significant improvement of motor function compared to sham-stimulation in the UPDRS (P < 0.001) and sRT (P = 0.019). This effect was not observed for cathodal stimulation of M1 or anodal stimulation of DLPFC. Furthermore, whereas anodal stimulation of M1 significantly increased MEP amplitude and area, cathodal stimulation of M1 significantly decreased them. There was a trend tow...