Cerebellar Transcranial Direct Current Stimulation in Parkinson’s Disease

Cerebellar Transcranial Direct Current Stimulation in Parkinson’s Disease

Publication date: Aug 06, 2019

Parkinson’s disease (PD) is the second most common neurodegenerative disorder and affects approximately 1 million people in the United States with total annual costs approaching 11 billion dollars. The most common symptoms of PD are tremor, stiffness, slowness, and trouble with balance/walking, which lead to severe impairments in performing activities of daily living. Current medical and surgical treatments for PD are either only mildly effective, expensive, or associated with a variety of side-effects. Therefore, the development of practical and effective add-ons to current therapeutic treatment approaches would have many benefits. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that can affect brain activity and can help make long-term brain changes to improve functions like walking and balance. While a few initial research studies and review articles involving tDCS have concluded that tDCS may improve PD walking and balance, many results are not meaningful in real life and several crucial issues still prevent tDCS from being a useful add-on intervention in PD. These include the selection of stimulation sites (brain regions stimulated) and tDCS electrode placement. Most studies have targeted the motor cortex (brain region that controls intentional movement), but there is evidence that the cerebellum – which helps control gait and balance, is connected to several other brain areas, and is easily stimulated with tDCS – may be a likely location to further optimize walking and balance in PD. There is also evidence that certain electrodes placements may be better than others. Thus, the purpose of this study is to determine the effects of cerebellar tDCS stimulation using two different placement strategies on walking and balance in PD. Additionally, although many tDCS devices are capable of a range of stimulation intensities (for example, 0 mA – 5 mA), the intensities currently used in most tDCS research are less than 2 mA, which is sufficient to produce measurable improvements; but, these improvements may be expanded at higher intensities. In the beginning, when the safety of tDCS was still being established for human subjects, careful and moderate stimulation approaches were warranted. However, recent work using stimulation at higher intensities (for example, up to 4 mA) have been performed in different people and were found to have no additional negative side-effects. Now that the safety of tDCS at higher intensities is better established, studies exploring the differences in performance between moderate (i.e., 2 mA) and higher (i.e., 4 mA) intensities are necessary to determine if increasing the intensity increases the effectiveness of the desired outcome. Prospective participants will include 10 people with mild-moderate PD that will be recruited to complete five randomly-ordered stimulation sessions, separated by at least 5 days each. Each session will involve one visit to the Integrative Neurophysiology Laboratory (INPL) and will last for approximately one hour. We expect data collection to take 4-6 months. Each session will include walking and balance testing performed while wearing the tDCS device. Total tDCS stimulation time for each session will be 25 minutes.

Concepts Keywords
Brain TDCS device
Cerebellar TDCS devices
Cerebellum Chronic psychiatric conditions
Dementia Movement disorder
Direct Current Injuries
Dopaminergic Surgical treatments
Electrode Surgeries
Foam Medicine
Force Clinical medicine
Gait Branches of biology
Iowa Electrotherapy
Motion Sensors Medical devices
Motor Cortex Neurotechnology
Movement Disorder Neurostimulation
Neurodegenerative Diseases Neurophysiology
Neurodegenerative Disorder Transcranial direct-current stimulation
Parkinson Deep brain stimulation
Psychoactive
Skull
Stiffness
TDCS
Telephone
Tremor

Semantics

Type Source Name
disease MESH neurodegenerative disorder
disease MESH tremor
drug DRUGBANK Isoxaflutole
disease MESH development
disease MESH gait
drug DRUGBANK Tropicamide
disease MESH separated
disease MESH diagnosis
disease MESH movement disorder
disease MESH dementia
disease DOID dementia
pathway BSID Neurodegenerative Diseases
gene UNIPROT NR4A2
gene UNIPROT ALG3
disease MESH Parkinson Disease
disease DOID Parkinson Disease

Similar

Original Article

Leave a Comment

Your email address will not be published. Required fields are marked *