Effects of tDCS on Sleep Disturbances, Mood, and Arousal Levels in Parkinson's Disease: Insights from Smart Device Monitoring

초록

Introduction This study aims to investigate the effects of sequential transcranial direct current stimulation (tDCS) treatments on sleep disturbances and their interplay with mood and motor symptoms in Parkinson’s disease (PD) patients, with smart devices used to objectively monitor sleep patterns and activity levels. Methods Twenty PD patients with depressive symptoms participated in 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 sleep duration, patterns, and daily activity levels. Pre- and post-tDCS data were analyzed using paired t-tests, Pearson’s correlation, and regression analyses to evaluate changes in sleep, mood, and motor outcomes. Results Although smart device data indicated no significant changes in total sleep duration post-tDCS, there was a significant increase in step counts (p = 0.012), suggesting an elevation in arousal levels. This increased arousal was correlated with mood improvements, as demonstrated by changes in MADRS scores (r = -0.47, p = 0.04). Regression analysis showed that changes in depressive symptoms explained 21.8% of the variance in step count (R² = 0.218, p = 0.04). However, no direct relationship was found between motor symptom improvements (UPDRS) and sleep duration. Conclusion While tDCS did not extend total sleep duration, the observed increase in step counts implies heightened arousal levels, potentially driven by improved mood. Smart device monitoring provided objective data on activity and sleep, supporting its use in comprehensive PD management. These findings underscore the importance of evaluating arousal levels and mood as interconnected components influencing sleep and daily activity in PD patients.