P73-S TACS and physical therapy for motor and cognitive symptoms in Parkinson’s disease: randomized cross-over trial

Abstract

Abnormal cortical oscillations are markers of Parkinson’s Disease (PD). Transcranial alternating current stimulation (tACS) can modulate brain oscillations and possibly impact on behaviour. Mapping of cortical activity (prevalent oscillatory frequency and topographic scalp distribution) may provide a personalized neurotherapeutic target and guide non-invasive brain stimulation. This is a cross-over, double blinded, randomized trial. Electroencephalogram (EEG) from participants with PD were recorded. TACS frequency/site were individually defined based on statistical comparison of EEG power spectra maps with normative data from our laboratory. Participants were randomized to tACS or random noise stimulation (RNS), 5 days/week for 2-weeks followed by ad hoc physical therapy. EEG, motor (Unified Parkinson’s Disease Rating Scale-motor: UPDRS III), neuropsychological (frontal, executive and memory tests) performance and mood were measured before (T0), after (T1) and 4-weeks after treatment (T2). A linear model with random effects and Wilcoxon test were used to detect differences. Main results include a reduction of beta rhythm in theta-tACS vs. RNS group at T1 over right sensorimotor area (p = 0.014) and left parietal area (p = 0.010) and at T2 over right sensorimotor area (p = 0.004) and left frontal area (p = 0.039). Bradykinesia items improved at T1 (p = 0.002) and T2 (p = 0.047) compared to T0 in the tACS group. In the tACS group the Montreal Cognitive Assessment (MoCA) improved at T2 compared with T1 (p = 0.049). Individualized tACS in PD improves motor and cognitive performance. These changes are associated with a reduction of excessive fast oscillations.