PARKINSONISM AND RELATED DISORDERS 134 (2025) 107596 IMPROVEMENT OF DEPRESSION AND MOTOR PARAMETERS AFTER APPLICATION OF TRANSCRANIAL DIRECT CURRENT STIMULATION IN PARKINSON'S DISEASE

초록

Background: This study aims to investigate the effectiveness of sequential transcranial direct current stimulation (tDCS) treatments on mood and motor symptoms in Parkinson's disease (PD) patients, incorporating smart devices to objectively assess the impact on daily activity levels and sleep disturbances. Methods: Twenty PD patients with depressive symptoms underwent ten sessions of tDCS treatment. Clinical assessments included the Unified Parkinson’s Disease Rating Scale (UPDRS), Montgomery-Åsberg Depression Rating Scale (MADRS), State-Trait Anxiety Inventory (STAI), Apathy Scale (AS), and Parkinson's Disease Questionnaire-39 items (PDQ-39). Smart devices recorded daily activity levels and sleep patterns. Pre- and post-tDCS data were analyzed using t-tests, Pearson's correlation, and regression analyses. Results: Significant improvements were observed in motor function and depression post-tDCS. Changes in MADRS scores correlated with changes in UPDRS scores (r=0.69, p=0.001), with MADRS changes explaining 47.5% of UPDRS score variability (R2=0.48, p=0.001). Smart device data showed no significant alterations in activity time or sleep duration but a significant increase in step counts (p=0.012), correlating with mood symptom changes (r=-0.47, p=0.04). Regression analyses revealed that MADRS score variations explained 21.8% of step count changes (R2=0.218, p=0.04). Conclusions: tDCS demonstrated efficacy in improving mood and motor symptoms in PD patients with depressive symptoms. Smart devices provided objective insights into daily activity levels, highlighting the potential for comprehensive monitoring and personalized interventions in PD management.