TRANSCRANIAL DIRECT-CURRENT STIMULATION IN COMBINATION WITH EXERCISE: A SYSTEMATIC REVIEW

ABSTRACT Introduction Transcranial direct-current stimulation (tDCS) is a noninvasive technique that allows the modulation of cortical excitability and can produce changes in neuronal plasticity. The application of tDCS has recently been associated with physical activity. Objectives To verify the effect of Transcranial Direct-Current Stimulation (tDCS) in combination with physical exercise, characterizing methodological aspects of the technique. Methods In the database search, studies with animals, other neuromodulation techniques and opinion and review articles were excluded. Publications up to 2016 were selected and the methodological quality of the articles was verified through the PEDro scale. Results The majority of studies (86%) used tDCS on the motor cortex area, with anodal current and the allocation of monocephalic electrodes (46.5%). The prevalent current intensity was 2mA (72%), with duration of 20min (55.8%). The profile of the research participants was predominantly of subjects aged up to 60 years (72.1%). The outcomes were favorable for the use of anodal tDCS in combination with physical exercise. Conclusion Transcranial Direct-Current Stimulation is a promising technique when used in combination with aerobic and anaerobic exercises; however, it is necessary to investigate concurrent exercise. Level of Evidence II; Therapeutic Studies Investigating the Results of Treatment (systematic review of Level II studies or Level I studies with inconsistent results).

摘要
引言：经颅直流电刺激（Transcranial direct-current stimulation, tDCS）是一种无创神经调控技术，可调节大脑皮层兴奋性并改变神经元可塑性。近年来，该技术的应用已与体育运动相结合。
研究目的：验证经颅直流电刺激联合体育运动的应用效果，并阐明该技术的方法学特征。
研究方法：数据库检索阶段，排除涉及动物实验、其他神经调控技术的研究以及观点类、综述类文献；最终纳入2016年及之前发表的相关文献，并通过PEDro量表评估纳入文献的方法学质量。
研究结果：绝大多数研究（86%）将tDCS应用于运动皮层区域，采用阳极电流与单头电极放置方式（占比46.5%）；主流刺激电流强度为2mA（占比72%），单次刺激时长为20分钟（占比55.8%）。研究对象的年龄分布以60岁及以下人群为主（占比72.1%）。所有研究结局均支持阳极经颅直流电刺激联合体育运动的应用有效性。
研究结论：经颅直流电刺激与有氧运动、无氧运动联合应用时展现出良好的应用前景，但仍需针对联合运动方案开展进一步探究。
证据等级：Ⅱ级；探究治疗效果的治疗性研究（针对Ⅱ级研究的系统评价，或结果不一致的Ⅰ级研究）。