Transcranial direct current stimulation associated with gait training in Parkinson’s disease: A pilot randomized clinical trial

Abstract

The CGT provided many benefits to functional mobility, motor impairment, bradykinesia, balance, and quality of life. However, these effect magnitudes were not influenced by stimulation, but tDCS seems to prolong the effects of cueing therapy on functional mobility.

Invasive and Noninvasive Brain Stimulation in Parkinson's Disease: Clinical Effects and Future Perspectives

“…Another study delivered tDCS to lower limb M1 area (at the Cz position) before gait training with cueing. Although the extent of improvement was not different from patients who received gait training alone, tDCS seemed to prolong the benefit . A study applied multibipolar tDCS electrodes simultaneously in both M1 and left DLPFC, M1 alone, or sham stimulation for 20 minutes in patients with PD with FOG.…”

“…Although the extent of improvement was not different from patients who received gait training alone, tDCS seemed to prolong the benefit. 118 A study applied multibipolar tDCS electrodes simultaneously in both M1 and left DLPFC, M1 alone, or sham stimulation for 20 minutes in patients with PD with FOG. The results showed significant improvement in gait-provoking test, Stroop, and time up and go tests after dual location tDCS, but not after M1 or sham stimulation.…”

Effects of More-Affected vs. Less-Affected Motor Cortex tDCS in Parkinson’s Disease

“…Another aspect that deserves to be discussed refers findings by some authors that in PD anodal tDCS can improve motor performances such as gait and balance only when combined with physical therapy (Kaski et al, 2014; Costa-Ribeiro et al, 2016a), likely thanks to the ability of anodal tDCS to enhance implicit motor learning (Nitsche et al, 2003b). On that account, future investigations are needed to assess whether the effects of the different tDCS montages on the upper limb motor function could be different or even more pronounced when applied in conjunction with a rehabilitation training program.…”

Parkinson's disease treatments: focus on transcranial direct current stimulation (tDCS)

“…29 Similarly, Schabrun et al 30 the time taken to complete a variety of motor sequences 10 times as a measure of bradykinesia. They found no benefit of tDCS above and beyond the gait training.…”

“…[43][44][45][46] From a neuroanatomical perspective, enhanced activation of the premotor cortex seems to be relevant for the improvement of motor performance induced by cueing therapy. 47 Thus, Costa-Ribeiro et al 29 investigated the effects of tDCS combined with cued gait training (CGT) on functional mobility in patients with PD. They conducted a pilot doubleblind controlled, randomized clinical trial with patients assigned either to anodal tDCS with CGT (n=12, one lost to follow-up) or to sham tDCS with CGT (n=12, one lost to follow-up).…”