Transcranial Pulsed Current Stimulation (tPCS) in Parkinson's Disease: A Pilot Trial.

IF 2.2 4区 医学 Q2 CLINICAL NEUROLOGY Canadian Journal of Neurological Sciences Pub Date : 2025-02-28 DOI:10.1017/cjn.2025.30
Dinkar Kulshreshtha, Olivia Samotus, Yokesh Tamilselvam, Jacky Ganguly, Dorian Aur, Mandar Jog
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Abstract

Background: Noninvasive stimulation techniques are a promising therapy due to the ease of administration and minimal side effects. We investigated the clinical, electrophysiological and side effects of transcranial pulsed current stimulation (tPCS) in patients with Parkinson's disease (PD).

Materials and methods: Ten PD patients were called at monthly intervals in the OFF levodopa state. Patients received active tPCS for 20 minutes in the first visit and sham stimulation for 20 minutes in the second and were assessed for the levodopa response in the third. Clinical and bradykinesia scoring and gait and tremor analysis were done before and after stimulation/sham/levodopa in each visit. Scalp electroencephalography (EEG) was recorded for quantitative analysis during each visit. The interventions were compared between pre- and post-intervention.

Results: A significant improvement with levodopa as compared to active and sham tPCS was seen in clinical scores. Upper limb postural tremor severity (z-score = -2.410, p = 0.016) and the stride velocity variability during post active stimulation improved by 20.7% compared to post sham stimulation though the difference was statistically non-significant. KINARM testing showed a statistically significant difference in the reaction time (p = 0.036) when comparing pre- and post-tPCS active stimulation. EEG recording showed a transitory increase of electrical activity after tPCS, with the most significant increase seen in alpha bandpower (p = 7.95*10-07; z score: -4.93).

Conclusions: tPCS was well tolerated in all patients. With minimal side effects, ease of administration and mild improvement in the electrophysiological parameters assessed, tPCS can be an alternative therapeutic option in patients with PD.

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经颅脉冲电流刺激(tPCS)治疗帕金森病:一项试点试验。
背景:无创刺激技术是一种很有前途的治疗方法,因为易于给药和最小的副作用。我们研究了经颅脉冲电流刺激(tPCS)治疗帕金森病(PD)的临床、电生理和副作用。材料与方法:10例PD患者在左旋多巴关闭状态下,每月随访一次。患者在第一次访问时接受20分钟的主动tPCS,第二次接受20分钟的假刺激,并在第三次访问时评估左旋多巴反应。在每次访问中进行刺激/假/左旋多巴前后的临床和运动迟缓评分以及步态和震颤分析。在每次访问期间记录头皮脑电图(EEG)进行定量分析。将干预前后进行比较。结果:左旋多巴治疗组的临床评分明显改善。主动刺激后上肢体位性震颤严重程度(z-score = -2.410, p = 0.016)和跨步速度变异性较假刺激后改善20.7%,但差异无统计学意义。KINARM测试显示,tpcs主动刺激前后的反应时间差异有统计学意义(p = 0.036)。脑电记录显示,tPCS后脑电活动有一过性增加,其中α带功率增加最为显著(p = 7.95*10-07;Z分数:-4.93)。结论:tPCS在所有患者中耐受性良好。tPCS具有副作用小、易于给药和电生理参数轻度改善的特点,可作为PD患者的替代治疗选择。
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来源期刊
CiteScore
4.30
自引率
3.30%
发文量
330
审稿时长
4-8 weeks
期刊介绍: Canadian Neurological Sciences Federation The Canadian Journal of Neurological Sciences is the official publication of the four member societies of the Canadian Neurological Sciences Federation -- Canadian Neurological Society (CNS), Canadian Association of Child Neurology (CACN), Canadian Neurosurgical Society (CNSS), Canadian Society of Clinical Neurophysiologists (CSCN). The Journal is a widely circulated internationally recognized medical journal that publishes peer-reviewed articles. The Journal is published in January, March, May, July, September, and November in an online only format. The first Canadian Journal of Neurological Sciences (the Journal) was published in 1974 in Winnipeg. In 1981, the Journal became the official publication of the member societies of the CNSF.
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