PDF(Pubmed)
Abstract：
UNASSIGNED: Transcranial Direct Current Stimulation (tDCS) of the cerebellum shows promise for the treatment of dystonia. Specific motor rehabilitation programs have also been developed in this context. However, the combination of these two approaches has not yet been evaluated to determine their therapeutic potential.
UNASSIGNED: We report a series of 5 patients with cervical dystonia (CD) poorly controlled by botulinum toxin injections. They were initially treated by a protocol of repeated daily sessions (for 3 or 5 days) of cerebellar anodal tDCS (cer-atDCS) applied alone. In a second time, additional protocols of cer-atDCS were performed in combination with a program of goal-oriented motor training exercises (Mot-Training), specifically developed for the treatment of CD. The clinical impact of the procedures was assessed on the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).
UNASSIGNED: Compared to baseline, the maximum percentage of TWSTRS total score improvement was 37% on average after cer-atDCS performed alone (p = 0.147, not significant) and 53% on average after cer-atDCS combined with Mot-Training (p = 0.014, significant). The TWSTRS pain and functional handicap subscores also improved after the combined protocol. A score of (+3) to (+5) was rated on the TWSTRS response scale after cer-atDCS performed alone or the combined protocol, corresponding to a moderate to striking improvement on dystonia and pain. This improvement lasted longer after the combined protocol than after cer-atDCS alone (3.4 vs. 1.4 months on average, p = 0.011).
UNASSIGNED: The combination of cer-atDCS with Mot-Training produced a greater and more prolonged improvement than the application of cer-atDCS alone. Such a combined therapeutic procedure is easy to perform and opens important perspectives in the long-term treatment of CD. These results remain to be confirmed by a randomized sham-controlled trial on a larger sample.
UNASSIGNED: We report a series of 5 patients with cervical dystonia (CD) poorly controlled by botulinum toxin injections. They were initially treated by a protocol of repeated daily sessions (for 3 or 5 days) of cerebellar anodal tDCS (cer-atDCS) applied alone. In a second time, additional protocols of cer-atDCS were performed in combination with a program of goal-oriented motor training exercises (Mot-Training), specifically developed for the treatment of CD. The clinical impact of the procedures was assessed on the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).
UNASSIGNED: Compared to baseline, the maximum percentage of TWSTRS total score improvement was 37% on average after cer-atDCS performed alone (p = 0.147, not significant) and 53% on average after cer-atDCS combined with Mot-Training (p = 0.014, significant). The TWSTRS pain and functional handicap subscores also improved after the combined protocol. A score of (+3) to (+5) was rated on the TWSTRS response scale after cer-atDCS performed alone or the combined protocol, corresponding to a moderate to striking improvement on dystonia and pain. This improvement lasted longer after the combined protocol than after cer-atDCS alone (3.4 vs. 1.4 months on average, p = 0.011).
UNASSIGNED: The combination of cer-atDCS with Mot-Training produced a greater and more prolonged improvement than the application of cer-atDCS alone. Such a combined therapeutic procedure is easy to perform and opens important perspectives in the long-term treatment of CD. These results remain to be confirmed by a randomized sham-controlled trial on a larger sample.
摘要：
■小脑的经颅直流电刺激（tDCS）显示出治疗肌张力障碍的希望。在这种情况下，还制定了特定的运动康复计划。然而,尚未对这两种方法的组合进行评估以确定其治疗潜力.
■我们报告了一系列5例通过肉毒杆菌毒素注射控制不佳的宫颈肌张力障碍（CD）患者。最初通过单独使用小脑阳极tDCS（cer-atDCS）的每日重复疗程（3或5天）的方案进行治疗。第二次，cer-atDCS的附加协议与目标导向的运动训练练习（Mot-Training）计划相结合，专门用于治疗CD。在多伦多西部痉挛性斜颈评定量表（TWSTRS）上评估了该程序的临床影响。
■与基线相比，单独进行cer-atDCS后,TWSTRS总分改善的最大百分比平均为37%(p=0.147,无显著性),cer-atDCS联合Mot-Training后,平均为53%(p=0.014,显著性).联合方案后，TWSTRS疼痛和功能障碍子评分也有所改善。在单独或联合方案进行cer-atDCS后，TWSTRS反应量表评分为（+3）至（+5），对应于肌张力障碍和疼痛的中度至显著改善。这种改进在联合方案后比单独使用cer-atDCS后持续的时间更长(3.4vs.平均1.4个月，p=0.011)。
■与单独使用cer-atDCS相比，cer-atDCS与Mot-Training的结合产生了更大，更长时间的改善。这种联合治疗程序易于执行，并在CD的长期治疗中开辟了重要的前景。这些结果仍有待更大样本的随机假对照试验证实。
■我们报告了一系列5例通过肉毒杆菌毒素注射控制不佳的宫颈肌张力障碍（CD）患者。最初通过单独使用小脑阳极tDCS（cer-atDCS）的每日重复疗程（3或5天）的方案进行治疗。第二次，cer-atDCS的附加协议与目标导向的运动训练练习（Mot-Training）计划相结合，专门用于治疗CD。在多伦多西部痉挛性斜颈评定量表（TWSTRS）上评估了该程序的临床影响。
■与基线相比，单独进行cer-atDCS后,TWSTRS总分改善的最大百分比平均为37%(p=0.147,无显著性),cer-atDCS联合Mot-Training后,平均为53%(p=0.014,显著性).联合方案后，TWSTRS疼痛和功能障碍子评分也有所改善。在单独或联合方案进行cer-atDCS后，TWSTRS反应量表评分为（+3）至（+5），对应于肌张力障碍和疼痛的中度至显著改善。这种改进在联合方案后比单独使用cer-atDCS后持续的时间更长(3.4vs.平均1.4个月，p=0.011)。
■与单独使用cer-atDCS相比，cer-atDCS与Mot-Training的结合产生了更大，更长时间的改善。这种联合治疗程序易于执行，并在CD的长期治疗中开辟了重要的前景。这些结果仍有待更大样本的随机假对照试验证实。
