Background

Since people with Parkinson disease (PD) rely on limited prefrontal executive resources for the control of gait, interventions targeting the prefrontal cortex (PFC) may help in managing PD-related gait impairments. Transcranial direct current stimulation (tDCS) can be used to modulate PFC excitability and improve prefrontal cognitive functions and gait.

Objective

We investigated the effects of adding anodal tDCS applied over the PFC to a session of aerobic exercise on gait, cognition, and PFC activity while walking in people with PD.

Methods

A total of 20 people with PD participated in this randomized, double-blinded, sham-controlled crossover study. Participants attended two 30-minute sessions of aerobic exercise (cycling at moderate intensity) combined with different tDCS conditions (active- or sham-tDCS), 1 week apart. The order of sessions was counterbalanced across the sample. Anodal tDCS (2 mA for 20 minutes [active-tDCS] or 10 s [sham-tDCS]) targeted the PFC in the most affected hemisphere. Spatiotemporal gait parameters, cognitive functions, and PFC activity while walking were assessed before and immediately after each session.

Results

Compared with the pre-assessment, participants decreased step time variability (effect size: −0.4), shortened simple and choice reaction times (effect sizes: −0.73 and −0.57, respectively), and increased PFC activity in the stimulated hemisphere while walking (effect size: 0.54) only after aerobic exercise + active-tDCS.

Conclusion

The addition of anodal tDCS over the PFC to a session of aerobic exercise led to immediate positive effects on gait variability, processing speed, and executive control of walking in people with PD.

中文翻译：

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有氧运动联合经颅直流电刺激帕金森病患者的前额叶皮层：对皮层活动、步态和认知的影响

背景

由于帕金森病 (PD) 患者依赖有限的前额叶执行资源来控制步态，因此针对前额叶皮层 (PFC) 的干预措施可能有助于管理与 PD 相关的步态障碍。经颅直流电刺激 (tDCS) 可用于调节 PFC 兴奋性并改善前额叶认知功能和步态。

客观的

我们调查了在 PFC 上添加阳极 tDCS 到有氧运动对 PD 患者行走时步态、认知和 PFC 活动的影响。

方法

共有 20 名 PD 患者参与了这项随机、双盲、假对照交叉研究。参与者参加了两次 30 分钟的有氧运动（中等强度骑自行车）结合不同的 tDCS 条件（主动或假 tDCS），相隔 1 周。整个样本中的会话顺序是平衡的。阳极 tDCS（2 mA 20 分钟 [active-tDCS] 或 10 s [sham-tDCS]）针对受影响最严重的半球的 PFC。在每次训练之前和之后立即评估行走时的时空步态参数、认知功能和 PFC 活动。

结果

与预评估相比，参与者减少了步长时间变异性（效应大小：-0.4），缩短了简单和选择反应时间（效应大小：分别为 -0.73 和 -0.57），并增加了行走时受刺激半球的 PFC 活动（效果大小：0.54）仅在有氧运动 + 主动 tDCS 后。

结论

在 PFC 上添加阳极 tDCS 到有氧运动会话中，对 PD 患者的步态变异性、处理速度和行走的执行控制产生了直接的积极影响。