Transcranial direct current stimulation provides no clinically important benefits over walking training for improving walking in Parkinson's disease: a systematic review

Nascimento, Lucas Rodrigues; Carmo, Willian Assis do; Oliveira, Gabriela Pinto de; Arêas, Fernando Zanela da Silva; Dias, Fernanda Moura Vargas

doi:10.1016/j.jphys.2021.06.003

Cited by 6 publications

(14 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to our analysis, two factors may have caused the above results. First, we consider that the diversity of the stimulation protocols utilized in each study was the cause (Lee et al, 2019;Nardone et al, 2020;de Oliveira et al, 2021;Nascimento et al, 2021;Pol et al, 2021;Deng et al, 2022;Krogh et al, 2022). Although our results did not reveal a statistically significant relationship between NIBS and gait speed, balance, or stride length, this does not mean that NIBS does not affect these outcomes.…”

Section: Figurementioning

confidence: 56%

“…Parkinson’s disease (PD) is the second most common neurological degenerative disease and the most common movement disorder, caused by the death of dopamine-producing cells in the substantia nigra ( Nascimento et al, 2021 ). The primary symptoms of PD manifest as movement-related features, including bradykinesia, rigidity, postural instability, and gait disturbances ( Obeso et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

“…There have been previous studies on the impact of NIBS on PD ( Helmich et al, 2006 ; Benninger and Hallett, 2015 ; Elsner et al, 2016 ), as well as several systematic reviews and meta-analyses ( Chou et al, 2015 ; Kim et al, 2019 ; Lee et al, 2019 ; Nardone et al, 2020 ; de Oliveira et al, 2021 ; Nascimento et al, 2021 ; Pol et al, 2021 ; Deng et al, 2022 ; Krogh et al, 2022 ). These studies assessed the effect of NIBS on motor symptoms ( de Oliveira et al, 2021 ), dyskinesia ( de Oliveira et al, 2021 ), and gait function ( Nardone et al, 2020 ; Pol et al, 2021 ; Deng et al, 2022 ) associated with PD.…”

Section: Introductionmentioning

confidence: 99%

“…These studies assessed the effect of NIBS on motor symptoms ( de Oliveira et al, 2021 ), dyskinesia ( de Oliveira et al, 2021 ), and gait function ( Nardone et al, 2020 ; Pol et al, 2021 ; Deng et al, 2022 ) associated with PD. However, most of these studies were based on independent assessments of the rTMS intervention ( Chou et al, 2015 ; Nardone et al, 2020 ; Deng et al, 2022 ; Krogh et al, 2022 ) and the tDCS intervention ( Lee et al, 2019 ; de Oliveira et al, 2021 ; Nascimento et al, 2021 ; Pol et al, 2021 ) and featured fewer participants. Moreover, these studies did not compare the two interventions or examine them combined.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of non-invasive brain stimulation on walking and balance ability in Parkinson’s patients: A systematic review and meta-analysis

Zhang

Fei-yue

Liu

et al. 2023

Front. Aging Neurosci.

View full text Add to dashboard Cite

ObjectiveTo investigate and contrast the effects of non-invasive brain stimulation (NIBS), including repeated transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), on walking and balance ability in patients with Parkinson’s disease (PD).MethodsThe PubMed, Embase, Medline, Cochrane, CNKI, and Chinese WanFang databases were searched up to June 2022. Quality assessment was performed using the Cochrane Collaboration’s risk-of-bias guidelines, and the standardized mean differences (SMD) or mean differences (MD) for each outcome were calculated.ResultsAmong 32 eligible studies, including 1,586 participants were analyzed in this meta-analysis. The results of the meta-analysis showed that NIBS was effective in improving UPDRS-III scores (MD = −2.07; 95% CI, −2.62 to −1.53; P < 0.00001; I2 = 6%) and variables associated with the ability of walk such as step width (SMD = 0.35; 95% CI, 0.16–0.55; P = 0.0005; I2 = 38%), cadence (SMD = 0.3; 95% CI, 0.05 to 0.55; P = 0.02; I2 = 25%), and 6MWT (MD = 62.86; 95% CI, 39.43–86.29; P < 0.00001; I2 = 0%). In subgroup analyses across intervention types, UPDRS-III scores (rTMS: MD = −2.54; 95% CI, −3.16 to −1.92; P < 0.00001; I2 = 0%; tDCS: MD = −1.20; 95% CI, −1.99 to −0.40; P = 0.003; I2 = 0%) and TUGT time (rTMS: MD = −4.11; 95% CI, −4.74 to −3.47; P < 0.00001; I2 = 0%; tDCS: MD = −0.84; 95% CI, −1.48 to −0.21; P = 0.009; I2 = 0%) significantly improved. Moreover, our results also showed that compared to tDCS, rTMS was more significant in improving UPDRS-III scores and TUGT time (p < 0.05).ConclusionNIBS benefits some walking ability variables but not balance ability in 36 patients with PD. The rTMS significantly improved UPDRS-III scores and TUGT time compared to tDCS. Further studies are needed to determine the optimal protocol and to illuminate effects based on the ideal target brain regions, stimulation intensity, timing, and type of intervention.Systematic review registrationhttp://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022350782.

show abstract

Section: Figurementioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of non-invasive brain stimulation on walking and balance ability in Parkinson’s patients: A systematic review and meta-analysis

Zhang

Fei-yue

Liu

et al. 2023

Front. Aging Neurosci.

View full text Add to dashboard Cite

show abstract

“…Thus, tDCS could potentially be used in walking training and has the potential to enhance its benefits ( Kaski et al, 2014b ; Schabrun et al, 2016 ; Costa-Ribeiro et al, 2017 ; Yotnuengnit et al, 2018 ). Some studies have shown that tDCS, in addition to gait training, did not produce clinically important effects on gait speed, stride length, or cadence in people with mild to moderate disabilities associated with PD ( Nascimento et al, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Fujikawa

Morigaki

Yamamoto

et al. 2022

Front. Aging Neurosci.

View full text Add to dashboard Cite

BackgroundPharmacotherapy is the first-line treatment option for Parkinson’s disease, and levodopa is considered the most effective drug for managing motor symptoms. However, side effects such as motor fluctuation and dyskinesia have been associated with levodopa treatment. For these conditions, alternative therapies, including invasive and non-invasive medical devices, may be helpful. This review sheds light on current progress in the development of devices to alleviate motor symptoms in Parkinson’s disease.MethodsWe first conducted a narrative literature review to obtain an overview of current invasive and non-invasive medical devices and thereafter performed a systematic review of recent randomized controlled trials (RCTs) of these devices.ResultsOur review revealed different characteristics of each device and their effectiveness for motor symptoms. Although invasive medical devices are usually highly effective, surgical procedures can be burdensome for patients and have serious side effects. In contrast, non-pharmacological/non-surgical devices have fewer complications. RCTs of non-invasive devices, especially non-invasive brain stimulation and mechanical peripheral stimulation devices, have proven effectiveness on motor symptoms. Nearly no non-invasive devices have yet received Food and Drug Administration certification or a CE mark.ConclusionInvasive and non-invasive medical devices have unique characteristics, and several RCTs have been conducted for each device. Invasive devices are more effective, while non-invasive devices are less effective and have lower hurdles and risks. It is important to understand the characteristics of each device and capitalize on these.

show abstract

Adaptive closed-loop control strategy inhibiting pathological basal ganglia oscillations

Wang

Zhu

et al. 2022

Biomedical Signal Processing and Control

View full text Add to dashboard Cite

Transcranial direct current stimulation provides no clinically important benefits over walking training for improving walking in Parkinson's disease: a systematic review

Cited by 6 publications

References 21 publications

Effects of non-invasive brain stimulation on walking and balance ability in Parkinson’s patients: A systematic review and meta-analysis

Effects of non-invasive brain stimulation on walking and balance ability in Parkinson’s patients: A systematic review and meta-analysis

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Adaptive closed-loop control strategy inhibiting pathological basal ganglia oscillations

Contact Info

Product

Resources

About