Abstract
BackgroundTranscranial direct current stimulation (tDCS) is a non-invasive brain stimulation to modulate cortical activity for improving motor function. However, the information of tDCS stimulation on different brain regions for dual-task walking and cortical modulation in Parkinson’s disease (PD) has not yet been compared.ObjectiveThe objective of this study was to investigate the effects of different tDCS targets on dual-task gait performance and cortical activity in patients with PD.MethodsA total of 36 participants were randomly assigned to primary motor cortex (M1) tDCS, dorsal lateral prefrontal cortex (DLPFC) tDCS, cerebellum tDCS, or Sham tDCS group. Each group received 20 min of tDCS stimulation, except for the Sham group. Gait performance was measured by the GAITRite system during dual-task walking and single walking. Corticomotor activity of the tibialis anterior (TA) was measured using transcranial magnetic stimulation (TMS). The functional mobility was assessed using the timed up and go (TUG) test.ResultsAll participants showed no significant differences in baseline data. Following the one session of tDCS intervention, M1 (p = 0.048), DLPFC (p < 0.001), and cerebellum (p = 0.001) tDCS groups demonstrated significant improvements in dual-task gait speed compared with a pretest. The time × group interaction [F(3, 32) = 5.125, p = 0.005] was detected in dual-task walking speed. The post hoc Tukey’s test showed that the differences in gait speed were between the Sham tDCS group and the DLPFC tDCS group (p = 0.03). Moreover, DLPFC tDCS also increased the silent period (SP) more than M1 tDCS (p = 0.006) and Sham tDCS (p = 0.002).ConclusionThe results indicate that DLPFC tDCS exerted the most beneficial effects on dual-task walking and cortical modulation in participants with PD.Clinical trial registration[http://www.thaiclinicaltrials.org/show/TCTR20200909005], Thai Clinical Trials Registry [TCTR20200909005].
Highlights
Parkinson’s disease (PD) is a degenerative neurological disease due to the loss of dopaminergic neurons in the substantia nigra pars compacta in basal ganglia (BG) (Lees et al, 2009)
36 patients were included in this study and were randomly assigned to the primary motor cortex (M1) Transcranial direct current stimulation (tDCS) group (n = 9), dorsal lateral prefrontal cortex (DLPFC) tDCS group (n = 9), cerebellum tDCS group (n = 9), or Sham tDCS group (n = 9)
No significant differences between groups were found in baseline demographic characteristics (Table 1) and all outcome measures at the pre-intervention assessment
Summary
Parkinson’s disease (PD) is a degenerative neurological disease due to the loss of dopaminergic neurons in the substantia nigra pars compacta in basal ganglia (BG) (Lees et al, 2009). In addition to classical motor symptoms, cognitive symptoms are widely accepted as part of the clinical feature in individuals with PD These motor and cognitive impairments increased their difficulties to perform complex daily activities, such as dual-task walking (i.e., responding to a cognitive demanding task while walking) (Benecke et al, 1986; Raffegeau et al, 2019). According to a meta-analysis, the gait speed and stride length decreased under the condition of dualtask walking as compared with single walking in people with PD (Raffegeau et al, 2019). These significant difficulties in dual-task walking may lead to increased disability, fall risks, and decreased quality of life in people with PD (Kelly et al, 2012). The information of tDCS stimulation on different brain regions for dual-task walking and cortical modulation in Parkinson’s disease (PD) has not yet been compared
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