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HD-tDCS as a neurorehabilitation technique for a case of post-anoxic leukoencephalopathy
Neuropsychological Rehabilitation ( IF 2.7 ) Pub Date : 2020-11-18 , DOI: 10.1080/09602011.2020.1845749
Sarah Garcia 1 , Benjamin M Hampstead 2, 3
Affiliation  

ABSTRACT

Post-anoxic leukoencephalopathy is a rare event that causes global demyelination secondary to anoxic injury. Given the nature and extent of the damage, cognitive and functional deficits are typically chronic even after standard therapies. Here, we describe a novel treatment approach that used high definition transcranial direct-current stimulation (HD-tDCS) with a 62-year-old male who was 5 years post-anoxic leukoencephalopathy secondary to an accidental drug overdose. HD-tDCS was administered over the left lateral prefrontal cortex across 29 daily sessions at 2 mA (20 min/session) in order to address dysexecutive behaviors. Results demonstrated improved delayed memory and trends for improved visuospatial and semantic fluency performance as well as improved insight and daily functioning, all of which returned to baseline by the end of a 10 week no-contact follow up period. Resting state fMRI connectivity results mirrored these changes by showing increased dorsal attention and cingulo-opercular but reduced ventral attention network connectivity after session 29, all of which returned to baseline at follow-up. These findings suggest HD-tDCS may benefit functioning even following serious and pervasive anoxic injury. Findings also suggest the need for continued HD-tDCS for maintenance purposes, though future work is needed to identify optimal dose-response information.



中文翻译:

HD-tDCS 作为神经康复技术治疗缺氧后白质脑病一例

摘要

缺氧后白质脑病是一种罕见的事件,会导致继发于缺氧损伤的全身脱髓鞘。鉴于损伤的性质和程度,认知和功能缺陷通常是慢性的,即使经过标准治疗也是如此。在这里,我们描述了一种新颖的治疗方法,该方法对一名 62 岁男性使用高清经颅直流电刺激 (HD-tDCS),该男性因意外药物过量继发缺氧性白质脑病 5 年后。HD-tDCS 以 2 mA(20 分钟/次)的电流在 29 个每日疗程中对左侧前额叶皮质进行治疗,以解决执行障碍行为。结果表明,延迟记忆有所改善,视觉空间和语义流畅性表现以及洞察力和日常功能都有改善的趋势,在 10 周的无接触随访期结束时,所有这些都恢复到基线。静息态 fMRI 连接结果反映了这些变化,第 29 节后,背侧注意力和扣带-盖骨连接性增加,但腹侧注意网络连接性减少,所有这些在随访时都恢复到基线。这些发现表明,即使在严重和普遍的缺氧损伤后,HD-tDCS 也可能有益于功能。研究结果还表明,出于维护目的,需要持续进行 HD-tDCS,尽管未来需要开展工作来确定最佳剂量反应信息。这些发现表明,即使在严重和普遍的缺氧损伤后,HD-tDCS 也可能有益于功能。研究结果还表明,出于维护目的,需要持续进行 HD-tDCS,尽管未来需要开展工作来确定最佳剂量反应信息。这些发现表明,即使在严重和普遍的缺氧损伤后,HD-tDCS 也可能有益于功能。研究结果还表明,出于维护目的,需要持续进行 HD-tDCS,尽管未来需要开展工作来确定最佳剂量反应信息。

更新日期:2020-11-18
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