The Effect of Non-invasive Brain Stimulation on Gait in Healthy Young and Older Adults: A Systematic Review of the Literature

Baharlouei, Hamzeh; Salehinejad, Mohammad Ali; Talimkhani, Ailin; Nitsche, Michael A.

doi:10.1016/j.neuroscience.2023.01.026

Cited by 4 publications

(8 citation statements)

References 105 publications

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“…The previous evidence for the remaining regions was insu cient. Direct comparisons of different regions regarding tDCS-induced effects on balance and postural control were almost non-existent [13,14,15]. Thus, our results provide an important contribution to this eld.…”

Section: Stimulated Area Speci C Modulationmentioning

confidence: 67%

“…Although the available data indicate that several cortical and subcortical brain regions, the cerebellum, and the spinal cord are crucially involved during motor control [10,11,12], the present applications of NIBS focus strongly on M1 [13,14,15]. The evidence for the remaining central and peripheral nervous system is insu cient, similar to studies that directly compare the effectiveness of NIBS over different areas [13,14,15]. Therefore, the question arises whether other regions may be comparable or even more promising for NIBS applications.…”

Section: Tdcs In the Modulation Of Balance And Postural Controlmentioning

confidence: 99%

“…Although several neuroimaging data indicate that several cortical and subcortical regions, the cerebellum, the brainstem and the spinal cord are crucially involved during balance and postural control [10,11,12], the majority of existing studies have applied tDCS over the M1 [13,14,15]. The previous evidence for the remaining regions was insu cient.…”

Section: Stimulated Area Speci C Modulationmentioning

confidence: 99%

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Spinal tDCS is superior to both M1 and cerebellar tDCS in supporting balance ability. A randomized, placebo-controlled trial

Veldema,

Steingräber,

Grönheim

et al. 2023

Preprint

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Objectives Existing applications of non-invasive brain stimulation in the modulation of balance ability are focused on the primary motor cortex (M1). It is conceivable that other brain and spinal cord areas may be comparable or more promising targets in this regard. This study compares transcranial direct current stimulation (tDCS) over (i) the M1, (ii) the cerebellum and (iii) the spinal cord in the modulation of balance ability. Methods Forty-two sports students were randomized in this placebo-controlled study. Twenty minutes of anodal 1.5 mA tDCS over (i) the M1, (ii) the cerebellum, and (iii) the spinal cord, as well as (iv) sham tDCS were applied to each subject. The Y Balance Test, Single Leg Landing Test, and Single Leg Squat Test were performed prior to and after each intervention. Results The Y Balance Test showed significant improvement after real stimulation of each region compared to sham stimulation. While spinal tDCS supported the balance ability of both legs, M1 and cerebellar tDCS supported right leg stand only. No significant differences were found on the Single Leg Landing Test and the Single Leg Squat Test. Conclusions Our data indicate that the spinal cord is a highly promising target for the application of non-invasive brain stimulation in supporting balance control. Future research could compare the effects of different spinal cord stimulation protocols on healthy people and examine the potential of this approach in neurorehabilitation.

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Section: Stimulated Area Speci C Modulationmentioning

confidence: 67%

Section: Tdcs In the Modulation Of Balance And Postural Controlmentioning

confidence: 99%

Section: Stimulated Area Speci C Modulationmentioning

confidence: 99%

See 1 more Smart Citation

Spinal tDCS is superior to both M1 and cerebellar tDCS in supporting balance ability. A randomized, placebo-controlled trial

Veldema,

Steingräber,

Grönheim

et al. 2023

Preprint

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“…The study’s exclusive focus on healthy participants introduced a limitation concerning the generalizability of findings to individuals with specific neurological disorders such as lower limb paralysis. Additionally, the effects of NIBS may manifest differently in diverse populations ( Huang et al, 2017 ; Ghasemian-Shirvan et al, 2020 ; Baharlouei et al, 2023 ). Therefore, caution should be observed when extrapolating our results to individuals with neurological disorders.…”

Section: Discussionmentioning

confidence: 99%

Predicting interindividual response to theta burst stimulation in the lower limb motor cortex using machine learning

Katagiri,

Saho,

Shibukawa

et al. 2024

Front. Neurosci.

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Using theta burst stimulation (TBS) to induce neural plasticity has played an important role in improving the treatment of neurological disorders. However, the variability of TBS-induced synaptic plasticity in the primary motor cortex prevents its clinical application. Thus, factors associated with this variability should be explored to enable the creation of a predictive model. Statistical approaches, such as regression analysis, have been used to predict the effects of TBS. Machine learning may potentially uncover previously unexplored predictive factors due to its increased capacity for capturing nonlinear changes. In this study, we used our prior dataset (Katagiri et al., 2020) to determine the factors that predict variability in TBS-induced synaptic plasticity in the lower limb motor cortex for both intermittent (iTBS) and continuous (cTBS) TBS using machine learning. Validation of the created model showed an area under the curve (AUC) of 0.85 and 0.69 and positive predictive values of 77.7 and 70.0% for iTBS and cTBS, respectively; the negative predictive value was 75.5% for both patterns. Additionally, the accuracy was 0.76 and 0.72, precision was 0.82 and 0.67, recall was 0.82 and 0.67, and F1 scores were 0.82 and 0.67 for iTBS and cTBS, respectively. The most important predictor of iTBS was the motor evoked potential amplitude, whereas it was the intracortical facilitation for cTBS. Our results provide additional insights into the prediction of the effects of TBS variability according to baseline neurophysiological factors.

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“…The present findings suggest that the primary motor cortex is implicated in walking fast in older adults and may be a useful target for rehabilitation. In support, transcranial direct current (tDCS) stimulation applied to the primary motor cortex has been shown to positively impact gait, improving gait speed, gait variability and synchronicity [ 106 , 107 ] and postural control [ 108 , 109 ]. In addition, peripheral neuromodulation therapies show promise for improving mobility and gait function in older adults by modifying sensory inputs and promoting neuroplasticity [ 110 ].…”

Section: Discussionmentioning

confidence: 99%

Faster Walking Speeds Require Greater Activity from the Primary Motor Cortex in Older Adults Compared to Younger Adults

Alcock

Vitório

Stuart

et al. 2023

Sensors

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Gait speed declines with age and slower walking speeds are associated with poor health outcomes. Understanding why we do not walk faster as we age, despite being able to, has implications for rehabilitation. Changes in regional oxygenated haemoglobin (HbO2) across the frontal lobe were monitored using functional near infrared spectroscopy in 17 young and 18 older adults while they walked on a treadmill for 5 min, alternating between 30 s of walking at a preferred and fast (120% preferred) speed. Gait was quantified using a triaxial accelerometer (lower back). Differences between task (preferred/fast) and group (young/old) and associations between regional HbO2 and gait were evaluated. Paired tests indicated increased HbO2 in the supplementary motor area (right) and primary motor cortex (left and right) in older adults when walking fast (p < 0.006). HbO2 did not significantly change in the young when walking fast, despite both groups modulating gait. When evaluating the effect of age (linear mixed effects model), greater increases in HbO2 were observed for older adults when walking fast (prefrontal cortex, premotor cortex, supplementary motor area and primary motor cortex) compared to young adults. In older adults, increased step length and reduced step length variability were associated with larger increases in HbO2 across multiple regions when walking fast. Walking fast required increased activation of motor regions in older adults, which may serve as a therapeutic target for rehabilitation. Widespread increases in HbO2 across the frontal cortex highlight that walking fast represents a resource-intensive task as we age.

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The Effect of Non-invasive Brain Stimulation on Gait in Healthy Young and Older Adults: A Systematic Review of the Literature

Cited by 4 publications

References 105 publications

Spinal tDCS is superior to both M1 and cerebellar tDCS in supporting balance ability. A randomized, placebo-controlled trial

Spinal tDCS is superior to both M1 and cerebellar tDCS in supporting balance ability. A randomized, placebo-controlled trial

Predicting interindividual response to theta burst stimulation in the lower limb motor cortex using machine learning

Faster Walking Speeds Require Greater Activity from the Primary Motor Cortex in Older Adults Compared to Younger Adults

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