Транскраниальная стимуляция постоянным током при болезни Паркинсона

Бордовский С.П., Андреев С.С., Муртазина Р.Т., Меинова Т.О., Таранова А.Д., Горлова Ю.И., Котенко В.Д., Зинченко О.О., Шевцова К.В. Транскраниальная стимуляция постоянным током при болезни Паркинсона. Consilium Medicum. 2025;27(11):659–664. DOI: 10.26442/20751753.2025.11.203455

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Bordovsky SP, Andreev SS, Murtazina RТ, Meinova ТО, Taranova АD, Gorlova IuI, Kotenko VD, Zinchenko ОО, Shevtsova KV. Transcranial direct current stimulation in Parkinson’s disease management. Consilium Medicum. 2025;27(11): 659–664. DOI: 10.26442/20751753.2025.11.203455

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Аннотация

Актуальность. Транскраниальная стимуляция постоянным током (ТСПТ) обсуждается как перспективный неинвазивный метод нейромодуляции для коррекции симптомов болезни Паркинсона (БП). Мало данных об эффективности ТСПТ при БП в нашей стране.
Цель. Оценить влияние курса неинвазивной анодной ТСПТ на моторные симптомы, когнитивные функции и эмоциональное состояние пациентов с БП.
Материалы и методы. В исследование включены 29 пациентов с БП I–III стадии (по Хен и Яру) в возрасте 45–80 лет. Всем проведен курс анодной ТСПТ дорсолатеральной префронтальной коры (2 мА, 20 мин, ежедневно 5 раз в неделю в течение 2 нед, всего 10 сеансов). До и после курса оценивали моторные функции (UPDRS-III – Unified Parkinson’s Disease Rating Scale), когнитивный статус (MoCA – Montreal Cognitive Assessment, FAB – Frontal Assessment Battery, Trail Making Test A/B – TMT-A, TMT-B) и эмоционально-аффективные показатели (шкала апатии, шкалы тревожности Спилбергера – личностная и ситуативная, шкала депрессии GDS – Geriatric Depression Scale).
Результаты. После курса ТСПТ отмечено статистически значимое улучшение когнитивных показателей (увеличение баллов MoCA, сокращение времени выполнения TMT-A и TMT-B), снижение двигательного дефицита (снижение баллов UPDRS-III), уменьшение выраженности апатии и личностной тревожности (p<0,05). Не найдено достоверных изменений по шкале FAB, ситуативной тревожности и шкале депрессии GDS. Не отмечено нежелательных явлений при проведении ТСПТ при БП.
Заключение. Курс ТСПТ безопасен и способен улучшать когнитивные функции, аффективные (апатия, тревожность) и моторные симптомы у пациентов с БП. Необходимы дальнейшие рандомизированные контролируемые исследования (с имитацией метода) для подтверждения эффективности ТСПТ при БП и уточнения оптимальных параметров стимуляции.

Ключевые слова: болезнь Паркинсона, транскраниальная стимуляция постоянным током, когнитивные нарушения, депрессия, апатия, тревожность, моторные нарушения

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Background. Transcranial direct current stimulation (tDCS) is discussed as a promising noninvasive neuromodulation method for alleviating symptoms of Parkinson’s disease (PD). However, evidence on the efficacy of tDCS in PD remains limited in our country.
Aim. To evaluate the effect of a course of noninvasive anodal tDCS on the motor symptoms, cognitive function, and emotional state of patients with PD.
Materials and methods. Twenty-nine patients with PD (Hoehn and Yahr stages I–III), aged 45–80 years, received anodal tDCS over the dorsolateral prefrontal cortex (DLPFC) at 2 mA for 20 minutes, once daily, 5 days per week for 2 weeks (10 sessions total). Pre- and post-treatment assessments included motor function (Unified Parkinson’s Disease Rating Scale, Part III [UPDRS-III]), cognition (Montreal Cognitive Assessment [MoCA], Frontal Assessment Battery [FAB], Trail Making Test Parts A and B [TMT-A/B]), and affective measures (Apathy Scale; State-Trait Anxiety Inventory-trait and state; Geriatric Depression Scale [GDS]).
Results. After the tDCS course, there was a statistically significant improvement in cognitive measures (higher MoCA scores and shorter TMT-A/B completion times), a reduction in motor deficit (lower UPDRS-III scores), and a decrease in apathy and trait anxiety (p<0,05). No significant changes were observed on the FAB, state anxiety, or GDS. No adverse events were reported during tDCS in PD.
Conclusion. A course of tDCS appears safe and may improve cognitive, affective (apathy, anxiety), and motor symptoms in PD. Randomized, sham-controlled trials are warranted to confirm efficacy and to determine optimal stimulation parameters.

Keywords: Parkinson’s disease, transcranial direct current stimulation, cognitive dysfunction, depression, apathy, anxiety, motor symptoms

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Список литературы

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9. Meira LB, Ferreira AT, Fernandes JVA, Oliveira ASB. Transcranial Direct Current Stimulation in Motor Therapy for Patients With Parkinson’s Disease: A Systematic Review. J Neurol Res. 2025;15(2):65-70. DOI:10.14740/jnr874
10. Beretta VS, Orcioli-Silva D, Zampier VC, et al. Eight sessions of transcranial electrical stimulation for postural response in people with Parkinson’s disease: A randomized trial. Gait Posture. 2024;114(1-7).
11. Liu J, Ying Z, Chen B, et al. Common and specific effects in brain oscillations and motor symptoms of tDCS and tACS in Parkinson’s disease. Cell Rep Med. 2025;6(4):102044. DOI:10.1016/j.xcrm.2025.102044
12. Starkstein SE, Mayberg HS, Preziosi TJ, et al. Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J Neuropsychiatry Clin Neurosci. 1992;4(2):134-9. DOI:10.1176/jnp.4.2.134
13. Suarez-Garcia DMA, Grisales-Cardenas JS, Zimerman M, Cardona JF. Transcranial Direct Current Stimulation to Enhance Cognitive Impairment in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Front Neurol. 2020;11. DOI:10.3389/fneur.2020.597955
14. Duan Z, Zhang C. Transcranial direct current stimulation for Parkinson’s disease: systematic review and metaanalysis of motor and cognitive effects. NPJ Parkinsons Dis. 2024;10(1):214. DOI:10.1038/s41531-024-00821-z
15. Chmiel J, Rybakowski F, Leszek J. Effect of Transcranial Direct Current Stimulation (tDCS) on Depression in Parkinson’s Disease – A Narrative Review. J Clin Med. 2024;13(3):699. DOI:10.3390/jcm13030699
16. Zheng EZ, Wong NML, Yang ASY, Lee TMC. Evaluating the effects of tDCS on depressive and anxiety symptoms from a transdiagnostic perspective: a systematic review and meta-analysis of randomized controlled trial. Transl Psychiatry. 2024;14(1):295. DOI:10.1038/s41398-024-03003-w18
17. Wei W, Yi X, Ruan J, et al. The efficacy of repetitive transcranial magnetic stimulation on emotional processing in apathetic patients with Parkinson’s disease: A Placebo-controlled ERP study. J Affect Disord. 2021;282:776-85. DOI:10.1016/j.jad.2020.12.099
18. Simpson MW, Mak M. The effect of transcranial direct current stimulation on upper limb motor performance in Parkinson’s disease: a systematic review. J Neurol. 2020;267(12):3479-88. DOI:10.1007/s00415-019-09385-y
19. Liu X, Liu H, Liu Z, et al. Transcranial Direct Current Stimulation for Parkinson’s Disease: A Systematic Review and Meta-Analysis. Front Aging Neurosci. 2021;13:746797. DOI:10.3389/fnagi.2021.746797
20. Almeida D, Wang Y, Pedreiro RCM, et al. Combining Transcranial Direct Current Stimulation with Exercise to Improve Mobility, Stability, and Tremor Management in 25 Individuals with Parkinson’s Disease. Neurol Int. 2024;16:1223-38. DOI:10.3390/neurolint16060093

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1. Reeve A, Simcox E, Turnbull D. Ageing and Parkinson’s disease: Why is advancing age the biggest risk factor? Ageing Res Rev. 2014;14(100):19-30. DOI:10.1016/j.arr.2014.01.004
2. Luo Y, Qiao L, Li M, et al. Global, regional, national epidemiology and trends of Parkinson’s disease from 1990 to 2021: findings from the Global Burden of Disease Study 2021. Front Aging Neurosci. 2024;16:1498756. DOI:10.3389/fnagi.2024.1498756
3. Su D, Cui Yu, He C, et al. Projections for prevalence of Parkinson’s disease and its driving factors in 195 countries and territories to 2050: modelling study of Global Burden of Disease Study 2021. BMJ. 2025;388:e080952. DOI:10.1136/bmj-2024-080952
4. Razdorskaya VV, Voskresenskaya ON, Yudina GK. Parkinson's disease in Russia: prevalence and incidence. Saratov Journal of Medical Scientific Research. 2016;12(3):379-84 (in Russian). EDN:YGHIPJ
5. Ma S, Zhuang W, Wang X, et al. Efficacy of transcranial direct current stimulation on cognitive function in patients with Parkinson’s disease: a systematic review and meta-analysis. Front Aging Neurosci. 2025;17:1495492. DOI:10.3389/fnagi.2025.1495492
6. Kwon DK, Kwatra M, Wang J, Ko HS. Levodopa-Induced Dyskinesia in Parkinson’s Disease: Pathogenesis and Emerging Treatment Strategies. Cells. 2022;11(23):3736. DOI:10.3390/cells11233736
7. Neuromodulation for Parkinson’s Disease APDA. Available at: https://www.apdaparkinson.org/article/neuromodulation-for-parkinsons-disease/ Accessed: 17.09.2025.
8. Wong PL, Yang YR, Huang ShF, et al. Transcranial Direct Current Stimulation on Different Targets to Modulate Cortical Activity and Dual-Task Walking in Individuals With Parkinson’s Disease: A Double Blinded Randomized Controlled Trial. Front Aging Neurosci. 2022;14:807151.
9. Meira LB, Ferreira AT, Fernandes JVA, Oliveira ASB. Transcranial Direct Current Stimulation in Motor Therapy for Patients With Parkinson’s Disease: A Systematic Review. J Neurol Res. 2025;15(2):65-70. DOI:10.14740/jnr874
10. Beretta VS, Orcioli-Silva D, Zampier VC, et al. Eight sessions of transcranial electrical stimulation for postural response in people with Parkinson’s disease: A randomized trial. Gait Posture. 2024;114(1-7).
11. Liu J, Ying Z, Chen B, et al. Common and specific effects in brain oscillations and motor symptoms of tDCS and tACS in Parkinson’s disease. Cell Rep Med. 2025;6(4):102044. DOI:10.1016/j.xcrm.2025.102044
12. Starkstein SE, Mayberg HS, Preziosi TJ, et al. Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J Neuropsychiatry Clin Neurosci. 1992;4(2):134-9. DOI:10.1176/jnp.4.2.134
13. Suarez-Garcia DMA, Grisales-Cardenas JS, Zimerman M, Cardona JF. Transcranial Direct Current Stimulation to Enhance Cognitive Impairment in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Front Neurol. 2020;11. DOI:10.3389/fneur.2020.597955
14. Duan Z, Zhang C. Transcranial direct current stimulation for Parkinson’s disease: systematic review and metaanalysis of motor and cognitive effects. NPJ Parkinsons Dis. 2024;10(1):214. DOI:10.1038/s41531-024-00821-z
15. Chmiel J, Rybakowski F, Leszek J. Effect of Transcranial Direct Current Stimulation (tDCS) on Depression in Parkinson’s Disease – A Narrative Review. J Clin Med. 2024;13(3):699. DOI:10.3390/jcm13030699
16. Zheng EZ, Wong NML, Yang ASY, Lee TMC. Evaluating the effects of tDCS on depressive and anxiety symptoms from a transdiagnostic perspective: a systematic review and meta-analysis of randomized controlled trial. Transl Psychiatry. 2024;14(1):295. DOI:10.1038/s41398-024-03003-w18
17. Wei W, Yi X, Ruan J, et al. The efficacy of repetitive transcranial magnetic stimulation on emotional processing in apathetic patients with Parkinson’s disease: A Placebo-controlled ERP study. J Affect Disord. 2021;282:776-85. DOI:10.1016/j.jad.2020.12.099
18. Simpson MW, Mak M. The effect of transcranial direct current stimulation on upper limb motor performance in Parkinson’s disease: a systematic review. J Neurol. 2020;267(12):3479-88. DOI:10.1007/s00415-019-09385-y
19. Liu X, Liu H, Liu Z, et al. Transcranial Direct Current Stimulation for Parkinson’s Disease: A Systematic Review and Meta-Analysis. Front Aging Neurosci. 2021;13:746797. DOI:10.3389/fnagi.2021.746797
20. Almeida D, Wang Y, Pedreiro RCM, et al. Combining Transcranial Direct Current Stimulation with Exercise to Improve Mobility, Stability, and Tremor Management in 25 Individuals with Parkinson’s Disease. Neurol Int. 2024;16:1223-38. DOI:10.3390/neurolint16060093

Авторы

С.П. Бордовский*¹, С.С. Андреев², Р.Т. Муртазина¹, Т.О. Меинова¹, А.Д. Таранова¹, Ю.И. Горлова¹, В.Д. Котенко¹, О.О. Зинченко², К.В. Шевцова¹

¹ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Минздрава России, Москва, Российская Федерация
²ФГАОУ ВО «Национальный исследовательский университет «Высшая школа экономики», Москва, Российская Федерация
*sbordoche@gmail.com

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Sergey P. Bordovsky*¹, Sergey S. Andreev², Renata T. Murtazina¹, Taisiya O. Meinova¹, Anna D. Taranova¹, Iuliia I. Gorlova¹, Valentina D. Kotenko¹, Oksana O. Zinchenko², Kseniya V. Shevtsova¹

¹Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
²National Research University Higher School of Economics, Moscow, Russian Federation
*sbordoche@gmail.com

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