Non-Invasive Cerebellar Stimulation in Neurodegenerative Ataxia: A Literature Review.

Alberto Benussi,Alvaro Pascual-Leone,Barbara Borroni

doi:10.3390/ijms21061948

Abstract

Cerebellar ataxias are a heterogenous group of degenerative disorders for which we currently lack effective and disease-modifying interventions. The field of non-invasive brain stimulation has made much progress in the development of specific stimulation protocols to modulate cerebellar excitability and try to restore the physiological activity of the cerebellum in patients with ataxia. In light of limited evidence-based pharmacologic and non-pharmacologic treatment options for patients with ataxia, several different non-invasive brain stimulation protocols have emerged, particularly employing repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) techniques. In this review, we summarize the most relevant rTMS and tDCS therapeutic trials and discuss their implications in the care of patients with degenerative ataxias.

Highlights

Cerebellar ataxias encompass a heterogenous group of acquired and hereditary disorders with diverse clinical presentations
We focus on the principal studies implementing non-invasive brain stimulation techniques, transcranial magnetic stimulation (TMS) and transcranial direct current stimulation, in the treatment of patients with degenerative ataxias
We searched articles in English published between Jan 1, 1996 and Jan 31, 2020 on Medline (PubMed) using the terms “ataxia”, in combination with “transcranial direct current stimulation” OR “transcranial magnetic stimulation” OR “repetitive transcranial magnetic stimulation” OR “brain stimulation” OR “cerebellar stimulation”

Summary

Introduction

Cerebellar ataxias encompass a heterogenous group of acquired and hereditary disorders with diverse clinical presentations They manifest clinically with a combination of signs and symptoms, such as balance and coordination disturbances, oculomotor deficits, dysarthria, dysmetria, and kinetic tremor [1]. Both the hereditary and sporadic forms of neurodegenerative ataxia usually present in young adulthood [2], and have an estimated prevalence of 3 in every 100,000 people [3]. We searched articles in English published between Jan 1, 1996 and Jan 31, 2020 on Medline (PubMed) using the terms “ataxia”, in combination with “transcranial direct current stimulation” OR “transcranial magnetic stimulation” OR “repetitive transcranial magnetic stimulation” OR “brain stimulation” OR “cerebellar stimulation”

TMS Techniques

Clinical Studies

Findings

Conclusions