单次经颅直流电刺激对儿童获得性脑损伤患者注意力的影响：表征个体间结构和功能网络反应变异性

IF 2.1 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-06-10 DOI:10.1016/j.pediatrneurol.2025.06.005

Athena Stein PhD, MPH , Kevin A. Caulfield PhD , Mervyn Singh PhD , Justin Riddle PhD , Maximilian A. Friehs PhD , Michael P. Craven PhD , Madeleine J. Groom PhD , Kartik K. Iyer PhD , Karen M. Barlow PhD, MSc, MBChB, MRCPCH

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引用次数: 0

摘要

大约四分之一的获得性脑损伤（ABI）儿童存在影响教育、就业和社区参与的注意力困难。这些困难来自于与注意力相关的大脑网络功能障碍，刺激了经颅直流电刺激（tDCS）的使用。我们调查了单次tDCS是否能改善儿童ABI后的注意力，以及基线结构连通性（sc）、功能连通性（fc）、注意力和/或模拟电场（E-fields）是否能解释反应的可变性。方法在一项随机、单盲、受试者内、假对照试验中，15名ABI患儿（平均12.7岁）和15名健康对照（hc）接受3次单次tDCS (1 mA背外侧前额叶皮层[dlPFC]， 1 mA额下回[IFG]，假手术；在游戏化注意力训练期间（20分钟）。我们根据侧卫和停止信号反应时间（RT）检查干预后注意的变化。我们使用多模态分析（高密度脑电图[HD-EEG]，扩散张量成像，磁共振成像）来研究tDCS反应的个体间变异性，根据RT变化与基线fc， sc，注意力和e场之间的关系。结果：虽然总体上没有发现主动与假性tDCS的影响，但在基线时具有较低theta或较高gamma默认模式网络连通性和较差注意力的参与者对tDCS的反应更大。更高的电场与更强的反应相关。未发生严重不良反应。结论针对dlPFC或IFG的单次tDCS治疗并不能改善儿童ABI后的注意力。我们演示了如何使用基于HD-EEG源的连接来个性化tDCS。未来的研究应该探索个性化和/或重复tDCS会话是否可以改善儿童ABI后的注意力。

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The Effect of a Single Session of Transcranial Direct Current Stimulation on Attention in Pediatric Acquired Brain Injury: Characterizing Interindividual Structural and Functional Network Response Variability

Background

Approximately one in four children who sustain an acquired brain injury (ABI) have attention difficulties impacting education, employment, and community participation. These difficulties arise from dysfunction in attention-related brain networks, incentivizing the use of transcranial direct current stimulation (tDCS). We investigated whether a single tDCS session improved attention following childhood ABI and whether baseline structural connectivity (sc), functional connectivity (fc), attention, and/or simulated electric fields (E-fields) explained variability in response.

Methods

In a randomized, single-blind, within-subject, sham-controlled trial, 15 children with ABI (mean 12.7 years) and 15 healthy controls (HCs) received three single tDCS sessions (1 mA dorsolateral prefrontal cortex [dlPFC], 1 mA inferior frontal gyrus [IFG], sham; 20 min) during gamified attention training. We examined postintervention changes in attention according to flanker and stop signal reaction time (RT). We used multimodal analyses (high-density electroencephalography [HD-EEG], diffusion tensor imaging, magnetic resonance imaging) to investigate interindividual variability in tDCS response, according to associations between RT change and baseline fc, sc, attention, and E-fields.

Results

Although no effect of active versus sham tDCS was found overall, participants with lower theta or higher gamma default mode network connectivity and poorer attention at baseline showed greater response to tDCS. Higher E-fields were associated with greater response. No serious adverse effects occurred.

Conclusions

A single tDCS session targeting dlPFC or IFG did not improve attention following pediatric ABI. We demonstrated how HD-EEG source-based connectivity may be used to personalize tDCS. Future research should explore whether personalization and/or repeated tDCS sessions can improve attention following pediatric ABI.

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.