Effects of Transcranial Direct Current Stimulation (tDCS) Associated with Balance Training in Individuals with Parkinson's: Study Protocol for a Randomized Clinical Trial

Overview

Journal MethodsX

Specialty Pathology

Date 2024 Dec 16

PMID 39676837

Authors

Raynara Fonseca Dos Santos

Guilherme Peixoto Tinoco Areas

Fernando Zanela da Silva Areas

Pedro Porto Alegre Baptista

Ayrles Silva Goncalves Barbosa Mendonca

Renato Campos Freire Junior

Affiliations

Soon will be listed here.

Abstract

The present study aimed to investigate the effects of balance training associated with cerebellar tDCS on postural control in individuals with PD. This is a randomized clinical trial in which individuals were allocated to an experimental group (EG) or placebo group (PG), in which a conventional protocol of 10 Physiotherapy sessions for locomotor training and postural control was applied. In the EG, tDCS was applied, with a current setting of 1.5 mA for 20 min simultaneously with postural control training. In the PG, tDCS was applied in sham mode, with the same electrode positioning and the same number of sessions as the EG. The sample compared 34 individuals with PD (EG: 17; PG: 17).Cerebellar tDCS associated with balance training may help improve postural control and balance in walkers with Parkinson's Disease. The hypothesis is, if walking improve, the benefits may be accompanied by better balance and reduced fear of falling, and individuals may experience greater free-living physical activity at home and in the community.

References

Kleiner A, Pacifici I, Vagnini A, Camerota F, Celletti C, Stocchi F . Timed Up and Go evaluation with wearable devices: Validation in Parkinson's disease. J Bodyw Mov Ther. 2018; 22(2):390-395. DOI: 10.1016/j.jbmt.2017.07.006. View

Ferrucci R, Cortese F, Priori A . Cerebellar tDCS: how to do it. Cerebellum. 2014; 14(1):27-30. PMC: 4318979. DOI: 10.1007/s12311-014-0599-7. View

Leddy A, Crowner B, Earhart G . Utility of the Mini-BESTest, BESTest, and BESTest sections for balance assessments in individuals with Parkinson disease. J Neurol Phys Ther. 2011; 35(2):90-7. PMC: 3178037. DOI: 10.1097/NPT.0b013e31821a620c. View

van der Kolk N, King L . Effects of exercise on mobility in people with Parkinson's disease. Mov Disord. 2013; 28(11):1587-96. DOI: 10.1002/mds.25658. View

Fasano A, Canning C, Hausdorff J, Lord S, Rochester L . Falls in Parkinson's disease: A complex and evolving picture. Mov Disord. 2017; 32(11):1524-1536. DOI: 10.1002/mds.27195. View

Tobar A, Jaramillo A, Costa S, Costa K, Garcia S . A Physical Rehabilitation Approach for Parkinson's Disease: A Systematic Literature Review. Cureus. 2023; 15(9):e44739. PMC: 10552785. DOI: 10.7759/cureus.44739. View

Na Y, Kim J, Lee S, Kim J, Lee J, Shin S . Multichannel Transcranial Direct Current Stimulation Combined With Treadmill Gait Training in Patients With Parkinson's Disease: A Pilot Study. Front Neurol. 2022; 13:804206. PMC: 8966669. DOI: 10.3389/fneur.2022.804206. View

Jurcak V, Tsuzuki D, Dan I . 10/20, 10/10, and 10/5 systems revisited: their validity as relative head-surface-based positioning systems. Neuroimage. 2007; 34(4):1600-11. DOI: 10.1016/j.neuroimage.2006.09.024. View

Lefaucheur J, Antal A, Ayache S, Benninger D, Brunelin J, Cogiamanian F . Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clin Neurophysiol. 2016; 128(1):56-92. DOI: 10.1016/j.clinph.2016.10.087. View

10.

Fregni F, El-Hagrassy M, Pacheco-Barrios K, Carvalho S, Leite J, Simis M . Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric Disorders. Int J Neuropsychopharmacol. 2020; 24(4):256-313. PMC: 8059493. DOI: 10.1093/ijnp/pyaa051. View

11.

Ntakou E, Nasios G, Nousia A, Siokas V, Messinis L, Dardiotis E . Targeting Cerebellum with Non-Invasive Transcranial Magnetic or Current Stimulation after Cerebral Hemispheric Stroke-Insights for Corticocerebellar Network Reorganization: A Comprehensive Review. Healthcare (Basel). 2022; 10(12). PMC: 9778071. DOI: 10.3390/healthcare10122401. View

12.

Schulz K, Altman D, Moher D . CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother. 2011; 1(2):100-7. PMC: 3043330. DOI: 10.4103/0976-500X.72352. View

13.

Radder D, Silva de Lima A, Domingos J, Keus S, van Nimwegen M, Bloem B . Physiotherapy in Parkinson's Disease: A Meta-Analysis of Present Treatment Modalities. Neurorehabil Neural Repair. 2020; 34(10):871-880. PMC: 7564288. DOI: 10.1177/1545968320952799. View

14.

Nascimento L, Carmo W, de Oliveira G, Areas F, Dias F . Transcranial direct current stimulation provides no clinically important benefits over walking training for improving walking in Parkinson's disease: a systematic review. J Physiother. 2021; 67(3):190-196. DOI: 10.1016/j.jphys.2021.06.003. View

15.

Yang L, Liao L, Lam F, He C, Pang M . Psychometric properties of dual-task balance assessments for older adults: a systematic review. Maturitas. 2015; 80(4):359-69. DOI: 10.1016/j.maturitas.2015.01.001. View

16.

Benninger D, Lomarev M, Lopez G, Wassermann E, Li X, Considine E . Transcranial direct current stimulation for the treatment of Parkinson's disease. J Neurol Neurosurg Psychiatry. 2010; 81(10):1105-11. PMC: 4162743. DOI: 10.1136/jnnp.2009.202556. View

17.

Capato T, de Vries N, IntHout J, Barbosa E, Nonnekes J, Bloem B . Multimodal Balance Training Supported by Rhythmical Auditory Stimuli in Parkinson's Disease: A Randomized Clinical Trial. J Parkinsons Dis. 2019; 10(1):333-346. PMC: 7029328. DOI: 10.3233/JPD-191752. View

18.

Faria C, Teixeira-Salmela L, Gomes Neto M, Rodrigues-De-Paula F . Performance-based tests in subjects with stroke: outcome scores, reliability and measurement errors. Clin Rehabil. 2011; 26(5):460-9. DOI: 10.1177/0269215511423849. View

19.

Kim S, Allen N, Canning C, Fung V . Parkinson disease. Handb Clin Neurol. 2018; 159:173-193. DOI: 10.1016/B978-0-444-63916-5.00011-2. View

20.

Hass C, Bishop M, Moscovich M, Stegemoller E, Skinner J, Malaty I . Defining the clinically meaningful difference in gait speed in persons with Parkinson disease. J Neurol Phys Ther. 2014; 38(4):233-8. DOI: 10.1097/NPT.0000000000000055. View