اثرات و عوارض tDCS در اختلالات حرکتی کودکان و نوجوانان

نوع مقاله : مقاله مروری

نویسندگان

1 دفتر تحقیقات و فن آوری دانشجویان. دانشجوی کارشناسی ارشد دانشکده علوم توانبخشی، شعبه بین الملل دانشگاه علوم پزشکی شهید بهشتی. تهران، ایران

2 دکترای فیزیوتراپی، استادیار گروه فیزیوتراپی دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی. تهران، ایران

3 دکترای فیزیوتراپی، استادگروه فیزیوتراپی دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی. تهران، ایران

10.22037/jrm.2016.1100206

چکیده

مقدمه و اهداف : مطالعات زیادی در موردتاثیر تحریک الکتریکی مغز با جریان مستقیم در بیماریهای مختلف در افراد بزرگسال انجام شده است اما در گروه کودکان و نوجوانان به دلیل نگرانیهای استفاده از این تحریک، مطالعات کمتری انجام شده است و مطالعات محدودی در سال های اخیر به بررسی اثرات این تحریک در این گروه پرداخته اند.
هدف از این مقاله بررسی تاثیر تحریک الکتریکی مغز در اختلالات حرکتی کودکان و نوجوانان و همینطور بررسی عوارض ناشی از تحریک در این گروه می باشد.
مواد و روشها :این مقاله مطالعه ای مروری است که درآن باجمع آوریاطلاعاتازطریقجستجودرمنابع جستجویChocrane,google scolar, Springer, PubMed, Ovid, Science Directاز سال 2000تا سال 2015 انجام شد و مطالعاتی که اثر و عوارض تحریک الکتریکی مغز از طریق جریان مستقیمرا دراختلالاتحرکتی کودکان و نوجوانان بررسی کرده بودند ، مورد مطالعه و بررسیقرار گرفتند.

یافتهها : از بین 162 مطالعه یافته شده در نهایت با توجه به معیار های ورود و خروج تنها 9 مطالعه باقی ماندند. تحریک الکتریکی مغز با جریان مستقیم همراه با درمانهای دیگر نظیر فیزیوتراپی معمول ،تردمیل و واقعیت مجازی در کودکان و نوجوانان در اندام تحتانی موجب بهبود تعادل و عملکرد راه رفتن و در اندام فوقانی کاهش اسپاستی سیته میگردد.در این مطالعات تنها اثرات سوء جزئی نظیر قرمزی ، سوزش و خارش پوست و گاه اختلال گذرای خلق گزارش شده است.همینطور این جریان نه تنها موجب تشنج نمیشود، بلکه بعنوان یک روش درمانی تشنج میتوانداستفاده شود .
نتیجه گیری: این جریان در کودکان غیراز سوزش و خارش و تغییرخلق به صورت گذرا،لااقل در کوتاه مدت اثرات نامطلوب دیگری ایجادنمی کند . همینطور وقتی این جریان با روشهای درمانی دیگر مورد استفاده قرار گیرد می تواند موجب ایجاد اثرات مفید درمانی در کودکان و نوجوانان دارای اختلال حرکتی گردد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effects and side effects of tDCS in movement disorders of children and adolescents

نویسندگان [English]

  • Nafiseh Saberi Najafabadi 1
  • Minoo Khalkhali Zavieh 2
  • Khosro Khademi Kalantari 3
1 Student Research Committee. MSc Student in Physiotherapy, School of Rehabilitation, International Branch, Shahid Beheshti University of Medical Sciences, Tehran. Iran
2 Assistant Professor of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran. Iran
3 Professor of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran. Iran
چکیده [English]

Background and Aim: Many studies about the effect of transcranial direct current stimulation have been carried out on different conditions in adults. But just few studies have been done in children and adolescents because of the concerns about this stimulation, and a few studies in recent years have studied the effects of this stimulation in this group.
The aim of this study was to investigate the effects and side effects of brain electrical stimulation in children and adolescents with movement disorders.
Materials & Methods: This article is a literature review, which was performed on studies in the period of 2000-2015, using Pub Med, Science Direct, OVID, Springer, Cochrane and Google scholar about the effects and side effects of tanscranial direct current stimulation in children and adolescents with motor disorders
Results: of 162 articles and based on the inclusion and exclusion criterias finaly 9 articles were chosen to be reviewed. These studies demonstrated that the combined use of tDCS and other treatments such as routine physical therapy, treadmill and virtual reality in children and adolescents improves the balance and gait parameter in lower limbs and decreases the spasticity in upper limbs. The only reported adverse effects In these studies were redness , itching burning and transient mood changes

This study showed that the electrical stimulation of the brain through direct current stimulation not only doesn’t cause seizures ,but also can be used as a therapeutic method in patients with seizures.
Conclusion : the results indicates that other than itching and mood change, this current in children and adolescents does not cause another adverse effects at least in the short term. When it is used with other treatments, it can cause desirable effects in children and adolescents with motor impairment.
Key words:tDCS ،Children, adolescense , , movement disorder, ،side effects.

کلیدواژه‌ها [English]

  • tDCS
  • children
  • adolescense
  • movement disorder
  • side effects
  1. Madhavan S, Shah B. Enhancing motor skill learning with transcranial direct current stimulation–a concise review with applications to stroke. Frontiers in psychiatry. 2012;3.##
  2. Minhas P, Bikson M, Woods AJ, Rosen AR, Kessler SK, editors. Transcranialdirect current stimulation in pediatric brain: a computational modeling study. Engineering in Medicine and Biology Society (EMBC), 2012 Annual International Conference of the IEEE; 2012: IEEE.##
  3. Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain stimulation. 2012;5(3):175-95.##
  4. Schlaug G, Renga V, Nair D. Transcranial direct current stimulation in stroke recovery. Archives of neurology. 2008;65(12):1571-6.##
  5. Liebetanz D, Nitsche MA, Tergau F, Paulus W. Pharmacological approach to the mechanisms of transcranial DC‐stimulation‐induced after‐effects of human motor cortex excitability. Brain. 2002;125(10):2238-47.##
  6. Nitsche MA, Liebetanz D, Antal A, Lang N, Tergau F, Paulus W. Modulation of cortical excitability by weak direct current stimulation--technical, safety and functional aspects. Supplements to Clinical neurophysiology. 2003;56:255.##
  7. Gomez Palacio Schjetnan A, Faraji J, Metz GA, Tatsuno M, Luczak A. Transcranial direct current stimulation in stroke rehabilitation: a review of recent advancements. Stroke research and treatment. 2013;2013.##
  8. Wu AD, Fregni F, Simon DK, Deblieck C, Pascual-Leone A. Noninvasive brain stimulation for Parkinson’s disease and dystonia. Neurotherapeutics. 2008;5(2):345-61.##
  9. Nitsche MA, Boggio PS, Fregni F, Pascual-Leone A. Treatment of depression with transcranial direct current stimulation (tDCS): a review. Experimental neurology. 2009;219(1):14-9.##

10. Auvichayapat N, Rotenberg A, Gersner R, Ngodklang S, Tiamkao S, Tassaneeyakul W, et al. Transcranial direct current stimulation for treatment of refractory childhood focal epilepsy. Brain stimulation. 2013;6(4):696-700.##

11. Fenton BW, Palmieri PA, Boggio P, Fanning J, Fregni F. A preliminary study of transcranial direct current stimulation for the treatment of refractory chronic pelvic pain. Brain stimulation. 2009;2(2):103-7.##

12. Chrysikou EG, Hamilton RH. Noninvasive brain stimulation in the treatment of aphasia: exploring interhemispheric relationships and their implications for neurorehabilitation. Restorative neurology and neuroscience. 2011;29(6):375.##

13. Fregni F, Marcondes R, Boggio P, Marcolin M, Rigonatti S, Sanchez Te, et al. Transient tinnitus suppression induced by repetitive transcranial magnetic stimulation and transcranial direct current stimulation. European Journal of Neurology. 2006;13(9):996-1001.##

14. D’Urso G, Ferrucci R, Bruzzese D, Pascotto A, Priori A, AltamuraCA, et al. Transcranial direct current stimulation for autistic disorder. Biol Psychiatry. 2014;76:e5-e6.##

15. Goldman RL, Borckardt JJ, Frohman HA, O’Neil PM, Madan A, Campbell LK, et al. Prefrontal cortex transcranial direct current stimulation (tDCS) temporarily reduces food cravings and increases the self-reported ability to resist food in adults with frequent food craving. Appetite. 2011;56(3):741-6.##

16. Andrade AC, Magnavita GM, Allegro JV, Neto CE, Lucena RD, Fregni F. Feasibility of transcranial direct current stimulation use in children aged 5 to 12 years. Journal of child neurology. 2014 Oct 1;29(10):1360-5.##

17. Rubio-Morell B, Rotenberg A, Hernandez-Exposito S, Pascual-Leone Á. [The use of noninvasive brain stimulation in childhood psychiatric disorders: new diagnostic and therapeutic opportunities and challenges]. Revista de neurologia. 2011;53(4):209-25.##

18. Kessler SK, Minhas P, Woods AJ, Rosen A, Gorman C, Bikson M. Dosage considerations for transcranial direct current stimulation in children: a computational modeling study. PloS one. 2013;8(9):e76112.##

19. Lu M, Thorlin T, Ueno S, Persson M. Comparison of maximum induced current and electric field from transcranial direct current and magnetic stimulations of a human head model. Piers Online. 2007;3(2):178-83.##

20. Gillick BT, Kirton A, Carmel JB, Minhas P, Bikson M. Pediatric stroke and transcranial direct current stimulation: methods for rational individualized dose optimization. Frontiers in human neuroscience. 2014;8.##

21. Freitas C, Mondragón-Llorca H, Pascual-Leone A. Noninvasive brain stimulation in Alzheimer's disease: systematic review and perspectives for the future. Experimental gerontology. 2011;46(8):611-27.##

22. Marlow NM, Bonilha HS, Short EB. Efficacy of transcranial direct current stimulation and repetitive transcranial magnetic stimulation for treating fibromyalgia syndrome: a systematic review. Pain Practice. 2013;13(2):131-45.##

23. Bastani A, Jaberzadeh S. Does anodal transcranial direct current stimulation enhance excitability of the motor cortex and motor function in healthy individuals and subjects with stroke: a systematic review and meta-analysis. Clinical Neurophysiology. 2012;123(4):644-57.##

24. Mattai A, Miller R, Weisinger B, Greenstein D, Bakalar J, Tossell J, et al. Tolerability of transcranial direct current stimulation in childhood-onset schizophrenia. Brain stimulation. 2011;4(4):275-80.##

25. Liebetanz D, Klinker F, Hering D, Koch R, Nitsche MA, Potschka H, et al. Anticonvulsant Effects of Transcranial Direct‐current Stimulation (tDCS) in the Rat Cortical Ramp Model of Focal Epilepsy. Epilepsia. 2006;47(7):1216-24.##

26. Yook S-W, Park S-H, Seo J-H, Kim S-J, Ko M-H. Suppression of seizure by cathodal transcranial direct current stimulation in an epileptic patient-a case report. Annals of rehabilitation medicine. 2011;35(4):579-82.##

27. Varga ET, Terney D, Atkins MD, Nikanorova M, Jeppesen DS, Uldall P, et al. Transcranial direct current stimulation in refractory continuous spikes and waves during slow sleep: a controlled study. Epilepsy research. 2011;97(1):142-5.##

28. Young SJ, Bertucco M, Sanger TD. Cathodal Transcranial Direct Current Stimulation in Children With Dystonia A Sham-Controlled Study. Journal of child neurology. 2013:0883073813492385.##

29. AuvichayapatN, Amatachaya A, Auvichayapat P. Reduction of Spasticity in Cerebral Palsy by Anodal Transcranial Direct Current Stimulation. J Med Assoc Thai. 2014;97(9):954-62.##

30. .Duarte NdAC, Grecco LAC, Galli M, Fregni F, Oliveira CS. Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial. PloS one. 2014;9(8):e105777.##

31. Grecco LAC, Duarte NdAC, Mendonça ME, Cimolin V, GalliM, Fregni F, et al. Transcranial direct current stimulation during treadmill training in children with cerebral palsy: A randomized controlled double-blind clinical trial. Research in developmental disabilities. 2014;35(11):2840-8.##

32. Grecco LAC, Mendonca ME, Duarte NA, Zanon N, Fregni F, Oliveira CS. Transcranial direct current stimulation combined with treadmill gait training in delayed neuro-psychomotor development. Journal of physical therapy science. 2014;26(6):945.##

33. Grecco LAC, Duarte NdAC, Mendonça ME, Galli M, Fregni F, Oliveira CS. Effects of anodal transcranial direct current stimulation combined with virtual reality for improving gait in children with spastic diparetic cerebral palsy: A pilot, randomized, controlled, double-blind, clinicaltrial. Clinical Rehabilitation. 2015:0269215514566997.##

34. Lazzari RD, Politti F, Santos CA, Dumont AJL, Rezende FL, Grecco LAC, et al. Effect of a single session of transcranial direct-current stimulation combined with virtual reality training on the balance of children with cerebral palsy: a randomized, controlled, double-blind trial. Journal of physical therapy science. 2015;27(3):763. ##