Transcranial direct current stimulation of dorsolateral prefrontal cortex improves dual-task gait performance in patients with Parkinson’s disease: A double blind, sham-controlled study

Mishra, Ram Kinker; Thrasher, Adam

doi:10.1016/j.gaitpost.2020.11.012

Cited by 34 publications

(62 citation statements)

References 27 publications

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“…Thirteen studies had a PEDro score of 9 and 10, representing excellent quality [ 26 , 32 , 38 , 39 , 42 – 49 ], four studies had a score of 8 [ 50 – 53 ], and one study had a score of 7 [ 27 ]. Sixteen studies were designed double-blinded.…”

Section: Resultsmentioning

confidence: 99%

“…In all studies, the allocation procedure was not described (Table 1 ). Five studies delivered data showing that the participants could not discriminate sham from real tDCS [ 39 , 44 , 48 – 50 ], while the other studies did not monitor discrimination between real and sham stimulation by the participants. Inter-rater agreement with respect to the PEDro scale ratings was calculated using Cohen’s kappa coefficient, and the resulting κ value was 0.82.…”

Section: Resultsmentioning

confidence: 99%

“…The mean disease duration ranged 4.3–11 years among the studies (Table 2 ). The disease severity was quantified by the Hoehn-Yahr scale in 12 studies [ 27 , 32 , 38 , 39 , 42 , 44 , 45 , 47 , 49 , 50 , 52 , 53 ] and the mean value reported in the studies was between 1.3 and 2.8.…”

Section: Resultsmentioning

confidence: 99%

“…In eight studies, tDCS was applied over the dorsolateral prefrontal cortex (DLPFC) to improve gait [ 39 , 42 – 45 , 47 , 51 , 52 ]. In four studies that reported an improvement of gait by the intervention, the anodal electrode was placed over F3 or F4 [ 39 , 43 , 45 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…The PEDro scale includes 11 items that rate the internal and external validity of a study. The first item, which refers to external validity, is not considered as part of the final PEDro score [ 38 , 39 ]. Two researchers (HB and FP) rated the articles independently, and any disagreements were resolved by discussion or, if required, with the consensus of a third reviewer (AS).…”

Section: Methodsmentioning

confidence: 99%

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The effects of transcranial direct current stimulation on gait in patients with Parkinson’s disease: a systematic review

Pol

Salehinejad

Baharlouei

et al. 2021

Transl Neurodegener

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Background Gait problems are an important symptom in Parkinson’s disease (PD), a progressive neurodegenerative disease. Transcranial direct current stimulation (tDCS) is a neuromodulatory intervention that can modulate cortical excitability of the gait-related regions. Despite an increasing number of gait-related tDCS studies in PD, the efficacy of this technique for improving gait has not been systematically investigated yet. Here, we aimed to systematically explore the effects of tDCS on gait in PD, based on available experimental studies. Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, PubMed, Web of Science, Scopus, and PEDro databases were searched for randomized clinical trials assessing the effect of tDCS on gait in patients with PD. Results Eighteen studies were included in this systematic review. Overall, tDCS targeting the motor cortex and supplementary motor area bilaterally seems to be promising for gait rehabilitation in PD. Studies of tDCS targeting the dorosolateral prefrontal cortex or cerebellum showed more heterogeneous results. More studies are needed to systematically compare the efficacy of different tDCS protocols, including protocols applying tDCS alone and/or in combination with conventional gait rehabilitation treatment in PD. Conclusions tDCS is a promising intervention approach to improving gait in PD. Anodal tDCS over the motor areas has shown a positive effect on gait, but stimulation of other areas is less promising. However, the heterogeneities of methods and results have made it difficult to draw firm conclusions. Therefore, systematic explorations of tDCS protocols are required to optimize the efficacy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

The effects of transcranial direct current stimulation on gait in patients with Parkinson’s disease: a systematic review

Pol

Salehinejad

Baharlouei

et al. 2021

Transl Neurodegener

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New Insights into Freezing of Gait in Parkinson's Disease from Spectral Dynamic Causal Modeling

Taniguchi,

Kajiyama,

Kochiyama

et al. 2024

Movement Disorders

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BackgroundFreezing of gait is one of the most disturbing motor symptoms of Parkinson's disease (PD). However, the effective connectivity between key brain hubs that are associated with the pathophysiological mechanism of freezing of gait remains elusive.ObjectiveThe aim of this study was to identify effective connectivity underlying freezing of gait.MethodsThis study applied spectral dynamic causal modeling (DCM) of resting‐state functional magnetic resonance imaging in dedicated regions of interest determined using a data‐driven approach.ResultsAbnormally increased functional connectivity between the bilateral dorsolateral prefrontal cortex (DLPFC) and the bilateral mesencephalic locomotor region (MLR) was identified in freezers compared with nonfreezers. Subsequently, spectral DCM analysis revealed that increased top‐down excitatory effective connectivity from the left DLPFC to bilateral MLR and an independent self‐inhibitory connectivity within the left DLPFC in freezers versus nonfreezers (>99% posterior probability) were inversely associated with the severity of freezing of gait. The lateralization of these effective connectivity patterns was not attributable to the initial dopaminergic deficit nor to structural changes in these regions.ConclusionsWe have identified novel effective connectivity and an independent self‐inhibitory connectivity underlying freezing of gait. Our findings imply that modulating the effective connectivity between the left DLPFC and MLR through neurostimulation or other interventions could be a target for reducing freezing of gait in PD. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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Effects of transcranial direct current stimulation combined with concurrent dual-task walking on mobility, gait, and cognitive outcomes: A systematic review

Usman,

Wong,

2025

Brain Research

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Transcranial direct current stimulation of dorsolateral prefrontal cortex improves dual-task gait performance in patients with Parkinson’s disease: A double blind, sham-controlled study

Cited by 34 publications

References 27 publications

The effects of transcranial direct current stimulation on gait in patients with Parkinson’s disease: a systematic review

The effects of transcranial direct current stimulation on gait in patients with Parkinson’s disease: a systematic review

New Insights into Freezing of Gait in Parkinson's Disease from Spectral Dynamic Causal Modeling

Effects of transcranial direct current stimulation combined with concurrent dual-task walking on mobility, gait, and cognitive outcomes: A systematic review

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