파킨슨병(PD) 환자의 우울증과 인지 기능에 고해상도 경두개 직류 자극(HD-tDCS)을 2세션 적용했을 때 모조 자극 대비 유의한 개선 효과를 보였다는 무작위 교차 연구 결과가 발표됐다.
*East Asian Archives of Psychiatry*에 게재된 이번 연구는 인도 찬디가르 소재 대학병원에서 우울 증상이 있는 경도~중등도 특발성 PD 환자 25명을 대상으로 진행됐다. 참여자는 활성군 또는 모조군에 무작위 배정됐으며, 30분 간격으로 20분씩 2세션의 왼쪽 배외측 전전두피질(DLPFC) 양극 자극을 받은 후 1주 휴약기를 거쳐 크로스오버했다.
사전 사후 평가는 몽고메리-오스버그 우울 척도(MADRS), 몬트리올 인지 평가(MoCA), MDS-UPDRS 1~3부, EQ-5D-5L로 이루어졌다. 분석 결과 MADRS(p=0.02), MoCA(p<0.01), MDS-UPDRS 1부(p=0.02), 2부(p<0.01), 3부(p<0.01), EQ-5D-5L(p=0.05) 모두에서 시간×군 상호작용이 통계적으로 유의했다. 활성군 참여자의 72%가 주관적 기분 변화를 보고했다.
부작용으로는 자극 부위의 가려움과 화끈거림이 보고됐으나 경미했다. 연구팀은 "2세션 HD-tDCS는 경도~중등도 PD 환자의 우울·인지 증상에 안전하고 내약성이 좋은 잠재적 효과적 중재"라고 결론지었다.
> 건강 팁: 파킨슨병 환자에서 우울증과 인지 저하는 운동 증상만큼이나 삶의 질에 영향을 미친다. 비침습적 뇌 자극 치료에 관심이 있다면 신경과 또는 정신건강의학과 전문의와 상담해 볼 것을 권한다.
📖 *HD-tDCS for Depressive and Non-Motor Symptoms in Parkinson's Disease* |
PubMedA novel brain stimulation technique has shown significant promise for treating depression and cognitive decline in Parkinson's disease, according to a randomised sham-controlled crossover study published in *East Asian Archives of Psychiatry*.
High-definition transcranial direct current stimulation (HD-tDCS) delivers low-intensity electrical current through a focused array of scalp electrodes, allowing more precise targeting of brain regions than conventional tDCS. Researchers at the Postgraduate Institute of Medical Education and Research in Chandigarh, India, tested whether two sessions of HD-tDCS targeting the left dorsolateral prefrontal cortex (DLPFC) could improve depressive and other non-motor symptoms in Parkinson's disease — a population in which depression affects roughly 40% of patients and significantly worsens quality of life.
Twenty-five patients with mild-to-moderate idiopathic Parkinson's disease and depressive symptoms were enrolled. Participants were randomly assigned to an active-first or sham-first sequence. The intervention consisted of two 20-minute sessions of anodal HD-tDCS at the left DLPFC, separated by a 30-minute interval, with assessments conducted at baseline and one week after each intervention, followed by a one-week washout before crossover.
Assessment tools included the Montgomery-Åsberg Depression Rating Scale (MADRS), Montreal Cognitive Assessment (MoCA), Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Parts 1–3, and EuroQol 5-Dimension 5-Level Scale (EQ-5D-5L).
Significant time-by-group interactions were found for all outcome measures: MADRS (p = 0.02), MoCA (p < 0.01), MDS-UPDRS Parts 1, 2, and 3 (p = 0.02, < 0.01, and < 0.01 respectively), and EQ-5D-5L (p = 0.05). A subjective mood improvement was reported by 72% of participants in the active group versus 48% in the sham group. Adverse effects were mild and limited to itching and burning sensations at the stimulation site.
> Health tip: Depression and cognitive decline in Parkinson's disease deserve as much attention as motor symptoms. If you or a loved one with Parkinson's is experiencing mood changes or memory difficulties, speak with a neurologist or psychiatrist about non-invasive treatment options.
📖 *HD-tDCS for Depressive and Non-Motor Symptoms in Parkinson's Disease* |
PubMed