顶叶高精度经颅直流电刺激对姿势控制的影响：一项单盲随机交叉研究

关键词：姿势控制  视觉运动控制  经颅直流电刺激  顶叶  感觉信息处理

Keywords:posture control  visual-motor control  transcranial direct current stimulation  parietal lobe  sensory information processing

摘要：

      摘要 目的：探索顶叶高精度经颅直流电刺激（high-definition transcranial direct current stimulation， HD-tDCS）是否可以改善静态或动态姿势控制能力。 方法：研究选取18例健康右利手成年人，采用单盲随机交叉实验设计。受试者接受4次顶叶阳极HD-tDCS（右侧、左侧、双侧和假刺激），每次干预前后进行单腿站立平衡测试、跳跃测试和轨迹追踪测试，分别得到平均重心摆动速度、稳定指数（前后向、左右向、垂直向和动态）以及平均绝对误差。采用双因素重复测量方差分析分析刺激前后、刺激类型对各指标的影响，使用Fisher事后检验来确定干预方式之间和干预时间前后是否存在差异。 结果：左右向轨迹追踪平均绝对误差结果仅存在时间（刺激前后）主效应（F（1，17）=6.693，P=0.019，ηP2=0.282），与干预前相比，仅左侧刺激组的平均绝对误差下降（P=0.03）。前后向轨迹追踪平均绝对误差结果仅存在时间（刺激前后）主效应（F（1，17）=5.921，P=0.026， ηP2=0.258），与干预前相比，仅双侧刺激组的平均绝对误差下降（P=0.015）。 结论：左侧及双侧顶叶HD-tDCS有助于提高视觉引导的动态姿势控制能力；本研究未发现单侧或双侧顶叶HD-tDCS对健康年轻人静态姿势控制能力产生影响。

Abstract:

      Abstract Objective： To explore whether high-definition transcranial direct current stimulation （HD-tDCS） of unilateral or bilateral parietal lobes would improve static or dynamic postural control. Method： A single-blind randomized crossover experimental design was used, , enrolling 18 healthy right-handed adults. Participants received four types of HD-tDCS interventions: right parietal, left parietal, bilateral parietal, and sham stimulation. Postural performance was assessed using the unilateral stance (US) test, jump-landing tasks, and curve-tracking test before and immediately after each intervention. Outcome measures included mean center of gravity (COG) sway velocity (US), anterior-posterior stability index (APSI), medial-lateral stability index (MLSI), vertical stability index (VSI), dynamic postural stability index (DPSI) (jump-landing tasks), and mean absolute error (MAE) (curve-tracking test). Two-way repeated-measures analyses of variance （ANOVAs） were used for the dependent variables. Fisher’s post hoc tests were used to determine differences between sessions as well as before and after intervention in case of significant ANOVA results. Result： A significant main effect of time was observed for MAE in the medial-lateral direction （F（1，17）=6.693，P=0.019， ηP2=0.282） and post hoc tests revealed a significant reduction in MAE following left parietal HD-tDCS（P=0.003）. The main effect of time is significant for MAE in the anterior-posterior direction （F（1，17）=5.921，P=0.026， ηP2=0.258） and post hoc tests revealed a significant reduction after bilateral parietal HD-tDCS（P=0.015）. Conclusion： Left and bilateral parietal lobe HD-tDCS can improve the visual-guided dynamic postural control. However, no significant effects on static postural control were observed in healthy young adults.