Treadmill Walking Combined With Anodal Transcranial Direct Current Stimulation in Parkinson Disease

Fernández‐Lago, Helena; Bello, Olalla; Mora-Cerdá, Francina; Montero-Cámara, Jorge; Fernández-del-Olmo, Miguel

doi:10.1097/phm.0000000000000751

Cited by 26 publications

(34 citation statements)

References 26 publications

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“…Overall, these data show that TMS can identify even subtle changes in the pathophysiology of the motor cortex and, as such, it may be more useful in the detection of very early stages of neurodegeneration than clinical observation alone. Indeed, the TMS profile we observed is similar to that reported by most of the studies in patients with early PD, [45][46][47][48][49][50][51] especially in the off-state, 87 thus suggesting that an early impairment of both glutamate and GABA might be detectable in RBD even in the absence of an overt extrapyramidal syndrome. 54 In agreement with this hypothesis, the occurrence of RBD in PD patients has been found to be associated more with neocortical, limbic, and thalamic denervation rather than nigro-striatal dopaminergic denervation, thus reasonably indicating a different etiology and pathophysiology compared to the typical PD manifestations.…”

Section: Main Findingssupporting

confidence: 86%

“…Most of previous studies found changes of both SICI and ICF in patients with PD, including those in the early stage, in terms of decreased SICI and reduced ICF, suggesting a disinhibition and hypofacilitation of the motor cortex. [45][46][47][48][49][50][51] To date, conversely, only one TMS study has been carried out in idiopathic RBD patients, 52 reporting an impairment of the short-latency afferent inhibition (SAI) and supporting the hypothesis of cholinergic dysfunction in those who develop cognitive impairment. This finding was also found in a second study by the same research group on patients with RBD associated to PD, again interpreted as the result of a cholinergic involvement correlated with their cognitive decline.…”

Section: Literature Backgroundmentioning

confidence: 99%

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Facilitatory/inhibitory intracortical imbalance in REM sleep behavior disorder: early electrophysiological marker of neurodegeneration?

Lanza

Aricò

Lanuzza

et al. 2019

Sleep

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Study Objectives Previous studies found an early impairment of the short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) to transcranial magnetic stimulation (TMS) in Parkinson’s disease. However, very little is known on the TMS correlates of rapid eye movement (REM) sleep behavior disorder (RBD), which can precede the onset of a α-synucleinopathy. Methods The following TMS measures were obtained from 14 de novo patients with isolated RBD and 14 age-matched healthy controls: resting motor threshold, cortical silent period, latency and amplitude of the motor evoked potentials, SICI, and ICF. A cognitive screening and a quantification of subjective sleepiness (Epworth Sleepiness Scale [ESS]) and depressive symptoms were also performed. Results Neurological examination, global cognitive functioning, and mood status were normal in all participants. ESS score was higher in patients, although not suggestive of diurnal sleepiness. Compared to controls, patients exhibited a significant decrease of ICF (median 0.8, range 0.5–1.4 vs. 1.9, range 1.4–2.3; p < 0.01) and a clear trend, though not significant, towards a reduction of SICI (median 0.55, range 0.1–1.4 vs. 0.25, range 0.1–0.3), with a large effect size (Cohen’s d: −0.848). REM Sleep Atonia Index significantly correlated with SICI. Conclusions In still asymptomatic patients for a parkinsonian syndrome or neurodegenerative disorder, changes of ICF and, to a lesser extent, SICI (which are largely mediated by glutamatergic and GABAergic transmission, respectively) might precede the onset of a future neurodegeneration. SICI was correlated with the muscle tone alteration, possibly supporting the proposed RBD model of retrograde influence on the cortex from the brainstem.

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Section: Main Findingssupporting

confidence: 86%

Section: Literature Backgroundmentioning

confidence: 99%

Facilitatory/inhibitory intracortical imbalance in REM sleep behavior disorder: early electrophysiological marker of neurodegeneration?

Lanza

Aricò

Lanuzza

et al. 2019

Sleep

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“…Anodal tDCS may also induce dopamine release in the basal ganglia by the activation of glutamatergic corticostriatal fibers (Siebner et al, 1999;Fregni et al, 2006;Valentino et al, 2014). Studies have been done by targeting either the motor cortex (M1, 1-2 mA, 13-30 min) (Verheyden et al, 2013;Kaski et al, 2014b;Mak and Yu, 2014;Valentino et al, 2014;Costa-Ribeiro et al, 2016Schabrun et al, 2016;Fernandez-Lago et al, 2017;da Silva et al, 2018;Yotnuengnit et al, 2018) or the dorsolateral prefrontal cortex (DLPFC, 2 mA, 7-20 min) (Manenti et al, 2014;Lattari et al, 2017). At post-stimulation, a short-term benefit in gait was noted in most of these studies.…”

Section: Transcranial Direct Current Stimulation Idiopathic Parkinsonmentioning

confidence: 99%

“…• Gait and balance (Benninger et al, 2010;Verheyden et al, 2013;Capecci et al, 2014;Kaski et al, 2014a;Mak and Yu, 2014;Manenti et al, 2014;Valentino et al, 2014;Costa-Ribeiro et al, 2016Schabrun et al, 2016;Swank et al, 2016;Fernandez-Lago et al, 2017;Lattari et al, 2017;Criminger et al, 2018;da Silva et al, 2018;Dagan et al, 2018;Harris et al, 2018;Yotnuengnit et al, 2018;Alizad et al, 2019;Putzolu et al, 2019) • Upper limb function (Fregni et al, 2006;Benninger et al, 2010;Doruk et al, 2014;Salimpour et al, 2015;Costa-Ribeiro et al, 2016;Ferrucci et al, 2016;Schabrun et al, 2016;Cosentino et al, 2017;Ishikuro et al, 2018;Broeder et al, 2019) • Cognition (Nitsche et al, 2005;Boggio et al, 2006;Biundo et al, 2015;Manenti et al, 2016;Elder et al, 2017;Lawrence et al, 2018;Adenzato et al, 2019) • Impulsive pathological gambling behavior (Benussi et al, 2017a) • Speech (Pereira et al, 2013) • Sleep (Hadoush et al, 2018) • Fatigue …”

Section: Mode Of Tesmentioning

confidence: 99%

Non-invasive Transcranial Electrical Stimulation in Movement Disorders

et al. 2020

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Dysfunction within large-scale brain networks as the basis for movement disorders is an accepted hypothesis. The treatment options for restoring network function are limited. Non-invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation are now being studied to modify the network. Transcranial electrical stimulation (tES) is also a portable, cost-effective, and non-invasive way of network modulation. Transcranial direct current stimulation and transcranial alternating current stimulation have been studied in Parkinson's disease, dystonia, tremor, and ataxia. Transcranial pulsed current stimulation and transcranial random noise stimulation are not yet studied enough. The literature in the use of these techniques is intriguing, yet many unanswered questions remain. In this review, we highlight the studies using these four potential tES techniques and their electrophysiological basis and consider the therapeutic implication in the field of movement disorders. The objectives are to consolidate the current literature, demonstrate that these methods are feasible, and encourage the application of such techniques in the near future. Keywords: non-invasive brain stimulation (NIBS), transcranial electrical stimulation (tES), transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), transcranial pulsed current stimulation (tPCS), transcranial random noise stimulation (tRNS)

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“…Emerging research suggests the potential for a-tDCS over the primary motor cortex (M1) to improve gait difficulties in PD due to the dense connectivity of the cortex and the basal ganglia, and the possibility of targeting the basal ganglia-thalamocortical motor circuits [ 22 – 27 ]. However, results from previous studies have indicated that the effects of tDCS on gait speed [ 24 , 26 – 34 ] and stride length [ 24 , 27 , 32 ] have been variable and appear to be dependent on stimulation site and electrode size. In one study, bilateral a-tDCS (3.5 × 5 cm 2 ) of either premotor and motor or prefrontal cortices with the cathode (5 × 5 cm 2 ) over the mastoid demonstrated significant improvement in gait speed [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of transcranial direct current stimulation on gait in people with Parkinson’s disease: study protocol for a randomized, controlled clinical trial

Alizad

Meinzer

Frossard

et al. 2018

Trials

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BackgroundGait difficulties are common and frequently devastating to people with Parkinson’s disease (PD). These difficulties are often followed by an increased risk of falls, leading to injury, hospitalization and mortality. The dysfunction in the basal ganglia-thalamocortical motor circuits and reduced activity in the premotor and primary motor cortices has raised interest in transcranial direct current stimulation (tDCS) as an adjunct intervention in PD. tDCS might provide a potentially safe and non-invasive treatment by modulating cortical excitability and behavioural outcomes. The aim of this study is to compare the effects of different monopolar and bipolar montages of tDCS administered to the motor cortex and cerebellum on gait speed in PD.MethodsThis study will be conducted in a randomized, double-blind cross-over design. Eighteen participants diagnosed with Parkinson’s disease will receive anodal and sham tDCS (1 mA, 20 min, 10 × 4 cm2) over the premotor and primary motor cortices with the cathode over the cerebellum during treadmill walking. Three montages will be applied over three sessions and compared: anodal tDCS with a small active cathode (4 × 4 cm2); anodal tDCS with a large, functionally inert cathode (10 × 10 cm2); and sham tDCS. The primary outcome measure is gait speed, and secondary outcome measures include gait parameters (temporospatial, segmental, kinematic), the Timed Up and Go test and lower limb muscle activity patterns as measured by electromyography.DiscussionThis study will investigate the short-term effects of anodal tDCS over the premotor and primary motor cortices on gait abilities using monopolar and bipolar montages in people with PD. The outcomes will inform future studies aimed at inducing longer-lasting changes in neural excitability and performance using multisession tDCS designs in PD.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618000063213. Registered on 17 January 2018. Retrospectively registered. Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2982-z) contains supplementary material, which is available to authorized users.

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Treadmill Walking Combined With Anodal Transcranial Direct Current Stimulation in Parkinson Disease

Cited by 26 publications

References 26 publications

Facilitatory/inhibitory intracortical imbalance in REM sleep behavior disorder: early electrophysiological marker of neurodegeneration?

Facilitatory/inhibitory intracortical imbalance in REM sleep behavior disorder: early electrophysiological marker of neurodegeneration?

Non-invasive Transcranial Electrical Stimulation in Movement Disorders

Effects of transcranial direct current stimulation on gait in people with Parkinson’s disease: study protocol for a randomized, controlled clinical trial

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