Cerebellar Transcranial Direct Current Stimulation in the Cerebellar Cognitive Affective Syndrome: A Randomized, Double-Blind, Sham-Controlled Trial.

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY Movement Disorders Pub Date : 2024-11-02 DOI:10.1002/mds.30043

Stacha F I Reumers, Roderick P P W M Maas, Dennis J L G Schutter, Steven Teerenstra, Roy P C Kessels, Frank-Erik de Leeuw, Bart P C van de Warrenburg

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Abstract

Background: The cerebellar cognitive affective syndrome (CCAS) encompasses cognitive and affective symptoms in patients with cerebellar disorders, for which no proven treatment is available.

Objectives: Our primary objective was to study the effect of cerebellar anodal transcranial direct current stimulation (tDCS) on cognitive performance in CCAS patients. Secondary effects on ataxia severity, mood, and quality of life were explored.

Methods: We performed a randomized, double-blind, sham-controlled trial. Thirty-five patients with CCAS were included and received 10 sessions of 20 minutes sham (n = 17) or real (n = 18) tDCS, with a current of 2 mA. Cognitive performance was assessed using executive function subtests of the computerized Test of Attentional Performance (TAP), with the composite as primary endpoint. Secondary outcomes were ataxia severity, mood, and quality of life. Outcomes were evaluated 1, 3, 6, and 12 months post-intervention.

Results: Cerebellar tDCS was well tolerated and no serious adverse events related to the intervention occurred. No significant tDCS effect was found on cognitive performance. Improvement on the TAP was observed in the sham group 1 month post-treatment (estimate = -0.248, 95% CI, -0.49 to -0.01), but not clinically relevant. A positive tDCS effect was observed for ataxia severity 1 month post-treatment (estimate = -0.985, 95% CI, -1.94 to -0.03).

Conclusions: Ten sessions of 20 minutes cerebellar anodal tDCS did not prove efficacious for CCAS-related cognitive impairment, but a significant positive effect of tDCS was found for ataxia severity, aligning with previous findings indicative of tDCS as a therapeutic neuromodulation tool in cerebellar disorders. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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小脑经颅直流电刺激治疗小脑认知情感综合征：随机、双盲、假对照试验》。

背景：小脑认知情感综合征（CCAS小脑认知情感综合征（CCAS）包括小脑疾病患者的认知和情感症状，目前尚无行之有效的治疗方法：我们的主要目的是研究小脑阳极经颅直流电刺激（tDCS）对CCAS患者认知能力的影响。目的：我们的首要目标是研究小脑阳极经颅直流电刺激（tDCS）对 CCAS 患者认知能力的影响，并探讨其对共济失调严重程度、情绪和生活质量的次要影响：我们进行了一项随机、双盲、假对照试验。35名CCAS患者接受了为期10次、每次20分钟、电流为2毫安的假性（n = 17）或真性（n = 18）tDCS治疗。认知表现采用计算机化注意力表现测试（TAP）的执行功能子测试进行评估，以综合结果作为主要终点。次要结果为共济失调严重程度、情绪和生活质量。对干预后1、3、6和12个月的结果进行评估：结果：小脑tDCS的耐受性良好，没有发生与干预相关的严重不良事件。tDCS对认知能力没有明显影响。治疗后1个月，在假组中观察到TAP有所改善（估计值=-0.248，95% CI，-0.49至-0.01），但与临床无关。在治疗后1个月，共济失调严重程度方面观察到了积极的tDCS效应（估计值=-0.985，95% CI，-1.94至-0.03）：结论：10次20分钟的小脑阳极tDCS治疗对CCAS相关认知障碍没有疗效，但对共济失调严重程度有显著的积极影响，这与之前的研究结果一致，表明tDCS是治疗小脑疾病的神经调节工具。© 2024 The Author(s).运动障碍》由 Wiley Periodicals LLC 代表国际帕金森和运动障碍协会出版。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.