Background:Balance and mobility impairments are frequent in people with multiple sclerosis, partly due to cerebellar dysfunctions. Task-oriented behavioural approaches were previously shown to promote physical function. The possibility exists that cerebellar transcranial direct current stimulation(ctDCS) applied during training, known to increase the excitability of the brain, can boost rehabilitation effects through modulation of cerebellum-brain inhibition. Objective:To test the efficacy of cerebellar ctDCS stimulation combined with motor training on mobility and balance in people with multiple sclerosis. Methods:16 subjects were randomly assigned to receive real- or sham-ctDCS and task-oriented training daily over two weeks in a double-blind, randomised clinical pilot trial. Functional mobility, balance, walking performance and quality of life were tested before and after treatment and at two-week follow-up. Effects of cerebellar stimulation on psychological and executive functions were also recorded. Results:Walking performance, balance and quality of life improved for both groups at post-treatment assessment which was maintained at 2-weeks follow up. A two-way ANOVA revealed a significant time effect for balance and walking performance. A significant interaction effect of time–treatment (F = 3.12, df = 2,26; p = 0.03) was found for motor aspects of quality of life assessment in patients who received real-ctDCS. Conclusions:Task-oriented training improves balance and mobility in people with multiple sclerosis, but ctDCS does not boost motor training effects.

中文翻译：

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小脑 tDCS 和面向任务的循环训练对多发性硬化症患者的综合影响：一项试点随机对照试验

背景：多发性硬化症患者经常出现平衡和行动障碍，部分原因是小脑功能障碍。以前显示以任务为导向的行为方法可以促进身体机能。有可能在训练期间应用小脑经颅直流电刺激 (ctDCS)，已知会增加大脑的兴奋性，可以通过调节小脑-大脑抑制来增强康复效果。目的：测试小脑 ctDCS 刺激联合运动训练对多发性硬化患者活动能力和平衡能力的影响。方法：在一项双盲、随机临床试验试验中，16 名受试者被随机分配在两周内每天接受真实或假 ctDCS 和任务导向训练。功能移动性、平衡性、在治疗前后以及两周的随访中测试了步行表现和生活质量。还记录了小脑刺激对心理和执行功能的影响。结果：在治疗后评估中，两组的行走能力、平衡和生活质量都有所改善，并在 2 周的随访中保持不变。双向方差分析揭示了平衡和步行性能的显着时间效应。在接受 real-ctDCS 的患者的生活质量评估的运动方面发现了时间-治疗的显着交互效应（F = 3.12，df = 2,26；p = 0.03）。结论：以任务为导向的训练可以改善多发性硬化症患者的平衡和活动能力，但 ctDCS 并不能提高运动训练效果。还记录了小脑刺激对心理和执行功能的影响。结果：在治疗后评估中，两组的行走能力、平衡和生活质量都有所改善，并在 2 周的随访中保持不变。双向方差分析揭示了平衡和步行性能的显着时间效应。在接受 real-ctDCS 的患者的生活质量评估的运动方面发现了时间-治疗的显着交互效应（F = 3.12，df = 2,26；p = 0.03）。结论：以任务为导向的训练可以改善多发性硬化症患者的平衡和活动能力，但 ctDCS 并不能提高运动训练效果。还记录了小脑刺激对心理和执行功能的影响。结果：在治疗后评估中，两组的行走能力、平衡和生活质量都有所改善，并在 2 周的随访中保持不变。双向方差分析揭示了平衡和步行性能的显着时间效应。在接受 real-ctDCS 的患者的生活质量评估的运动方面发现了时间-治疗的显着交互效应（F = 3.12，df = 2,26；p = 0.03）。结论：以任务为导向的训练可以改善多发性硬化症患者的平衡和活动能力，但 ctDCS 并不能提高运动训练效果。在 2 周随访中维持的治疗后评估中，两组的平衡和生活质量都得到了改善。双向方差分析揭示了平衡和步行性能的显着时间效应。在接受 real-ctDCS 的患者的生活质量评估的运动方面发现了时间-治疗的显着交互效应（F = 3.12，df = 2,26；p = 0.03）。结论：以任务为导向的训练可以改善多发性硬化症患者的平衡和活动能力，但 ctDCS 并不能提高运动训练效果。在 2 周随访中维持的治疗后评估中，两组的平衡和生活质量都得到了改善。双向方差分析揭示了平衡和步行性能的显着时间效应。在接受 real-ctDCS 的患者的生活质量评估的运动方面发现了时间-治疗的显着交互效应（F = 3.12，df = 2,26；p = 0.03）。结论：以任务为导向的训练可以改善多发性硬化症患者的平衡和活动能力，但 ctDCS 并不能提高运动训练效果。