Can transcranial direct current stimulation on the dorsolateral prefrontal cortex improves balance and functional mobility in Parkinson’s disease?

Abstract

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique increasingly explored for Parkinson's disease (PD). Although evidence is still inconsistent, there are preliminary findings suggesting its efficacy to improve motor function in individuals with PD, as the role of secondary motor areas remains unclear. The goal of this study was to investigate the effects of left dorsolateral prefrontal cortex (DLPFC) tDCS on balance and functional mobility of individuals with PD. Seventeen individuals with PD, on-medication, aged between 40 and 90 years were recruited to enroll in a double-blind, randomized, cross-over trial. Each participant completed two conditions at least 48h apart, namely anodal-tDCS and sham-tDCS (placebo). The a-tDCS condition targeted the left DLPC (F3) and was applied during 20min using a 2mA current intensity. In the sham-tDCS condition, electrode position remained the same but the stimulator was turned off after 30s. Functional mobility and balance were assessed using the Berg Balance Scale, Dynamic Gait Index and Timed Up and Go. There were significant differences between conditions on all outcome measures, as the a-tDCS condition was associated with better performance in comparison to the sham condition (p<0.05). Our findings suggest that a-tDCS on the left DLPFC improves balance and functional mobility in comparison to sham-tDCS. Compensatory mechanisms that support motor function in individuals with PD may have been enhanced by a-tDCS on the DLPFC, leading to improved functional mobility and balance. Future trials should explore left DLPFC stimulation with larger samples and compare t-DCS protocols targeting several brain regions.

Anodal tDCS over prefrontal cortex improves dual‐task walking in Parkinsonian patients with freezing

“…This finding fits well with the recent idea that gait disturbances in PD patients with FoG might be the consequence of an altered integration in the striatum of cognitive, emotional, and sensory information coming from the prefrontal and limbic regions . Neuromodulation over the left DLPFC to date has produced controversial findings in PD, likely because of bias in patients' recruitment or in the selected gait outcome measures . The dual‐task paradigm highlights the cognitive contribution to gait control: when patients are asked to walk while performing another task, changes in walking performance may rely on the cognitive capacity to integrate different task demands, and FoG often occurs while performing dual tasks.…”

Alternative Strategies for Managing Insomnia: The Case of Physical Exercise and Transcranial Direct Current Stimulation. A Narrative Review

“…Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that applies a lowintensity and continuous current that presumably induces cortical excitability changes [48]. tDCS has been used for multiple health purposes [48][49][50][51][52][53].…”

“…tDCS has been used for multiple health purposes [48][49][50][51][52][53]. Regarding the use of tDCS in insomnia, the role of prefronto-thalamic-cerebellar circuit on cognitive dysfunctions and sleep quality in euthymic bipolar disorder (BD) patients have showed that tDCS (2 mA) for 20 min/day during 3 consecutive weeks applied to left dorsolateral prefrontal cortex (DLPFC) and right cerebellar cortex improved sleep [54].…”

Transcranial Direct Current Stimulation for the Treatment of Parkinson's Disease: Clinical and Regional Cerebral Blood Flow SPECT Outcomes

“…Parkinson's disease (PD) is associated with both motor symptoms, including bradykinesia, tremor, rigidity, and postural instability, as well as a number of nonmotor features . Dopaminergic medication continues to be the mainstay of medical treatment for PD, but the options in use today only provide symptomatic relief and do not control or prevent disease progression . Moreover, the beneficial effects of medical treatment diminish and side effects emerge with time.…”