Gait speed after applying anodal-transcranial Direct Current Stimulation in people with Parkinson’s disease?

Abstract

During the last few years, there has been an emerging interest in non-pharmacological treatment of gait difficulties in Parkinson’s disease (PD) due to the side effects of PD medications. Non-pharmacological approaches, such as current physical rehabilitation strategies have only limited effectiveness in improving gait abilities in PD.Deep brain stimulation is expensive, and have highly invasive nature and potential severe side effects. Transcranial Direct Current Stimulation (tDCS) is one of the non-invasive and low cost approaches that might be beneficial in improving gait abilities in PD. The objective of this study was to explore the effects of anodal-tDCS with two different montages on gait speed in people with PD. Twelve volunteer participants with PD (aged 40-80 years; 3 women, 5 men; MDS-UPDRS score: 39.03±10.50) participated in this cross-over, sham-tDCS controlled study. Participants were assigned to receive bilateral anodal-tDCS (1 mA, 20 minutes) of the pre- and primary motor cortices (anode: 10×4 cm2) with either a small active cathode (4×4 cm 2 ) (tDCS active1) or large functionally inert cathode (10×10 cm 2) (tDCS active2) placed over the cerebellum, or sham-tDCS while walking on a treadmill. The sham or two anodal-tDCS conditions occurred in a randomised order over three sessions one week apart. Gait speed was measured using the Vicon Nexus system (2.6) on an even surface before and after each tDCS session. The tDCS active1 combined with treadmill walking significantly increased gait speed when comparing post-test versus pre-test in both PD and non PD participants. Both sham-tDCS and tDCS active2 combined with treadmill walking significantly improved gait speed only in PD participants. This finding suggests that bilateral tDCS of the pre-and primary motor cortices combined with treadmill walking may have short-term therapeutic effects on gait speed. However, these effects need to be confirmed in a larger population of people with PD.