Short-Term Efficacy of Cerebello-spinal tDCS and Body Weight-Supported Treadmill Training in the Hypertrophic Olivary Degeneration: a Rare Case Report

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Abstract

The present case study reported a patient diagnosed with hypertrophic olivary degeneration, a rare condition characterized by a trans-neuronal degeneration and signal enhancement in T2-weighted images on magnetic resonance imaging, usually caused by cerebral hemorrhage, cerebral infarction, and trauma. Furthermore, the relevant literature review was performed. The existing pharmacological treatment has limited clinical benefits on the patient. Since spontaneous remission hardly occurs in the disease, there are no other effective treatments. In this case, the patient was a 55-year-old Chinese male who presented progressive gait difficulty for several months due to both-sided ataxia. Neurological examination revealed upper extremity and lower limb bilateral spasticity, ataxia, slurred speech, and dysmetria. Therefore, our study treated the patient through the inventive application of cerebello-spinal transcranial direct current stimulation and body weight-supported treadmill training. After a 4-week treatment, the patient could walk independently, without aid, speeding up by 7%, as well as the ataxia symptoms, and balance has improved significantly. It was demonstrated in this case report that the combination of cerebello-spinal tDCS and body weight-supported treadmill training can be an effective treatment for patients with Hypertrophic olivary degeneration.

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脑脊髓 tDCS 和体重支持跑步机训练对肥厚性橄榄叶变性的短期疗效:罕见病例报告
摘要 本病例研究报告了一名被诊断为肥大性橄榄变性的患者,这是一种罕见的疾病,其特征是经神经元变性和磁共振成像 T2 加权图像信号增强,通常由脑出血、脑梗塞和外伤引起。此外,还进行了相关文献综述。现有的药物治疗对患者的临床疗效有限。由于该病几乎不会自发缓解,因此没有其他有效的治疗方法。在本病例中,患者是一名 55 岁的中国男性,由于双侧共济失调,数月来出现进行性步态困难。神经系统检查显示其上肢和下肢双侧痉挛、共济失调、言语不清和构音障碍。因此,我们的研究通过创造性地应用脑脊髓经颅直流电刺激和体重支撑跑步机训练对患者进行了治疗。经过 4 周的治疗,患者可以独立行走,无需辅助,行走速度提高了 7%,共济失调症状和平衡能力也得到了明显改善。本病例报告表明,脑脊髓 tDCS 与体重支撑跑步机训练相结合可有效治疗肥厚性橄榄变性患者。
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