Cerebellar Transcranial Direct Current Stimulation (ctDCS) Impairs Balance Control in Healthy Individuals

Abstract

The cerebellum plays an important role in the planning, initiation and stability of movements, as well as in postural control and balance. Modulation of neural regions underlying balance control may be a potential alternative to treat balance impairments in cerebellar patients. Transcranial direct current stimulation (tDCS) is a noninvasive and safe tool capable to modulate cerebellar activity. We aim to investigate the effects of cerebellar tDCS (ctDCS) on postural balance in healthy individuals. Fifteen healthy and right-handed subjects were submitted to three sessions of ctDCS (anodal, cathodal and sham), separated by at least 48 h. In each session, tests of static (right and left Athlete Single Leg tests) and dynamic balance (Limits of Stability test) were performed using the Biodex Balance System before and immediately after the ctDCS. The results revealed that cathodal ctDCS impaired static balance of healthy individuals, reflected in higher scores on overall stability index when compared to baseline for right (p = 0.034) and left (p = 0.01) Athlete Single Leg test. In addition, we found significant impairment for left Athlete Single Leg test in comparison to sham stimulation (p = 0.04). As far as we know, this is the first study that points changes on balance control after ctDCS in healthy individuals. This finding raises insights to further investigation about cerebellar modulation for neurological patients.

The effects of cerebellar transcranial direct current stimulation on static and dynamic postural stability in older individuals: a randomized double‐blind sham‐controlled study

“…() also investigated the effect of one‐session prefrontal tDCS on center of pressure (COP) fluctuations during single and dual tasks and showed increased COP complexity and postural control improvement during tDCS intervention in older adults (Zhou et al ., ). A number of some studies also investigated the effect of cerebellar tDCS on posture and balance in healthy individuals (Inukai et al ., ; Foerster et al ., ). Similar to our study, static and dynamic postural stability were assessed by BBS before and immediately after cerebellar tDCS in healthy individual (Foerster et al ., ).…”

“…A number of some studies also investigated the effect of cerebellar tDCS on posture and balance in healthy individuals (Inukai et al ., ; Foerster et al ., ). Similar to our study, static and dynamic postural stability were assessed by BBS before and immediately after cerebellar tDCS in healthy individual (Foerster et al ., ). This study reported static postural control changes and increased overall PSI by cerebellar cathodal tDCS in healthy individuals (Foerster et al ., ).…”

“…Similar to our study, static and dynamic postural stability were assessed by BBS before and immediately after cerebellar tDCS in healthy individual (Foerster et al ., ). This study reported static postural control changes and increased overall PSI by cerebellar cathodal tDCS in healthy individuals (Foerster et al ., ). It seems that cerebellar tDCS can modulate cerebellar–motor cortex connectivity and positively affect motor, cognitive and postural control processing (Celnik, ).…”

“…In addition, some studies reported the positive effects of prefrontal a‐tDCS on postural control and balance during dual tasking in healthy older adults (Zhou et al ., ; Manor et al ., ). Some studies assessing the polarity effect of cerebellar tDCS also indicated positive effect of cerebellar tDCS on posture and balance in healthy individuals (Inukai et al ., ; Foerster et al ., ). Due to the fact that cerebellum plays a more crucial role in maintenance of posture and balance compared to M1 (Prentice & Drew, ) and also by considering the significant effects of aging on the size, morphology, and function of cerebellum in older adults (Rosano et al ., ; Cavallari et al ., ; Bernard & Seidler, ), the cerebellum has been chosen as the stimulation site in the current study.…”

Consensus Paper: Cerebellum and Emotion

“…Most of these articles relate to the investigations of the physiological mechanisms of cerebellar stimulation in a healthy population. These studies focus primarily on different motor functions such as visuomotor adaptation [16], motor learning [17], or balance control [18], but some also focus on cognitive functions such as probabilistic classification learning [19], verb generation [20], or attentional control [21]. Recently, Oldrati and Schutter [22] published a quantitative review of 32 shamcontrolled studies employing cerebellar tDCS to modulate both motor-and non-motor-related cerebellar functions.…”