Effectiveness of acute transcranial direct current stimulation on non-motor and motor symptoms in Parkinson’s disease

2019 ◽  
Vol 696 ◽  
pp. 46-51 ◽  
Author(s):  
Maria Eduarda Brandão Bueno ◽  
Luiz Inácio do Nascimento Neto ◽  
Marcelle Brandão Terra ◽  
Natália Mariano Barboza ◽  
Alexandre Hideki Okano ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Motor Symptoms ◽  
Direct Current Stimulation

scholarly journals Transcranial Direct Current Stimulation on Parkinson's Disease: Systematic Review and Meta-Analysis

2022 ◽  
Vol 12 ◽  
Author(s):  
Paloma Cristina Alves de Oliveira ◽  
Thiago Anderson Brito de Araújo ◽  
Daniel Gomes da Silva Machado ◽  
Abner Cardoso Rodrigues ◽  
Marom Bikson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Meta Analysis ◽  
Motor Fluctuations ◽  
Motor Symptoms ◽  
Z Score ◽  
Direct Current Stimulation

Background: Clinical impact of transcranial direct current stimulation (tDCS) alone for Parkinson's disease (PD) is still a challenge. Thus, there is a need to synthesize available results, analyze methodologically and statistically, and provide evidence to guide tDCS in PD.Objective: Investigate isolated tDCS effect in different brain areas and number of stimulated targets on PD motor symptoms.Methods: A systematic review was carried out up to February 2021, in databases: Cochrane Library, EMBASE, PubMed/MEDLINE, Scopus, and Web of science. Full text articles evaluating effect of active tDCS (anodic or cathodic) vs. sham or control on motor symptoms of PD were included.Results: Ten studies (n = 236) were included in meta-analysis and 25 studies (n = 405) in qualitative synthesis. The most frequently stimulated targets were dorsolateral prefrontal cortex and primary motor cortex. No significant effect was found among single targets on motor outcomes: Unified Parkinson's Disease Rating Scale (UPDRS) III – motor aspects (MD = −0.98%, 95% CI = −10.03 to 8.07, p = 0.83, I2 = 0%), UPDRS IV – dyskinesias (MD = −0.89%, CI 95% = −3.82 to 2.03, p = 0.55, I2 = 0%) and motor fluctuations (MD = −0.67%, CI 95% = −2.45 to 1.11, p = 0.46, I2 = 0%), timed up and go – gait (MD = 0.14%, CI 95% = −0.72 to 0.99, p = 0.75, I2 = 0%), Berg Balance Scale – balance (MD = 0.73%, CI 95% = −1.01 to 2.47, p = 0.41, I2 = 0%). There was no significant effect of single vs. multiple targets in: UPDRS III – motor aspects (MD = 2.05%, CI 95% = −1.96 to 6.06, p = 0.32, I2 = 0%) and gait (SMD = −0.05%, 95% CI = −0.28 to 0.17, p = 0.64, I2 = 0%). Simple univariate meta-regression analysis between treatment dosage and effect size revealed that number of sessions (estimate = −1.7, SE = 1.51, z-score = −1.18, p = 0.2, IC = −4.75 to 1.17) and cumulative time (estimate = −0.07, SE = 0.07, z-score = −0.99, p = 0.31, IC = −0.21 to 0.07) had no significant association.Conclusion: There was no significant tDCS alone short-term effect on motor function, balance, gait, dyskinesias or motor fluctuations in Parkinson's disease, regardless of brain area or targets stimulated.

scholarly journals Frontal Transcranial Direct Current Stimulation as a Potential Treatment of Parkinson’s Disease-Related Fatigue

2021 ◽  
Vol 11 (4) ◽  
pp. 467
Author(s):  
Tino Zaehle
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cortical Excitability ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Motor Symptoms ◽  
Direct Current Stimulation ◽  
Non Motor Symptoms

In contrast to motor symptoms, non-motor symptoms in Parkinson’s disease (PD) are often poorly recognized and inadequately treated. Fatigue is one of the most common non-motor symptoms in PD and affects a broad range of everyday activities, causes disability, and substantially reduces the quality of life. It occurs at every stage of PD, and once present, it often persists and worsens over time. PD patients attending the 2013 World Parkinson Congress voted fatigue as the leading symptom in need of further research. However, despite its clinical significance, little progress has been made in understanding the causes of Parkinson’s disease-related fatigue (PDRF) and developing effective treatment options, which argues strongly for a greater effort. Transcranial direct current stimulation (tDCS) is a technique to non-invasively modulate cortical excitability by delivering low electrical currents to the cerebral cortex. In the past, it has been consistently evidenced that tDCS has the ability to induce neuromodulatory changes in the motor, sensory, and cognitive domains. Importantly, recent data present tDCS over the frontal cortex as an effective therapeutic option to treat fatigue in patients suffering from multiple sclerosis (MS). The current opinion paper reviews recent data on PDRF and the application of tDCS for the treatment of fatigue in neuropsychiatric disorders to further develop an idea of using frontal anodal tDCS as a potential therapeutic strategy to alleviate one of the most common and severe non-motor symptoms of PD.

scholarly journals The effects of transcranial direct current stimulation on gait in patients with Parkinson’s disease: a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Fateme Pol ◽  
Mohammad Ali Salehinejad ◽  
Hamzeh Baharlouei ◽  
Michael A. Nitsche
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Randomized Clinical Trials ◽  
Cortical Excitability ◽  
Experimental Studies ◽  
Gait Rehabilitation ◽  
Direct Current Stimulation

Abstract Background Gait problems are an important symptom in Parkinson’s disease (PD), a progressive neurodegenerative disease. Transcranial direct current stimulation (tDCS) is a neuromodulatory intervention that can modulate cortical excitability of the gait-related regions. Despite an increasing number of gait-related tDCS studies in PD, the efficacy of this technique for improving gait has not been systematically investigated yet. Here, we aimed to systematically explore the effects of tDCS on gait in PD, based on available experimental studies. Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, PubMed, Web of Science, Scopus, and PEDro databases were searched for randomized clinical trials assessing the effect of tDCS on gait in patients with PD. Results Eighteen studies were included in this systematic review. Overall, tDCS targeting the motor cortex and supplementary motor area bilaterally seems to be promising for gait rehabilitation in PD. Studies of tDCS targeting the dorosolateral prefrontal cortex or cerebellum showed more heterogeneous results. More studies are needed to systematically compare the efficacy of different tDCS protocols, including protocols applying tDCS alone and/or in combination with conventional gait rehabilitation treatment in PD. Conclusions tDCS is a promising intervention approach to improving gait in PD. Anodal tDCS over the motor areas has shown a positive effect on gait, but stimulation of other areas is less promising. However, the heterogeneities of methods and results have made it difficult to draw firm conclusions. Therefore, systematic explorations of tDCS protocols are required to optimize the efficacy.

Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease

2006 ◽  
Vol 21 (10) ◽  
pp. 1693-1702 ◽  
Author(s):  
Felipe Fregni ◽  
Paulo S. Boggio ◽  
Marcelo C. Santos ◽  
Moises Lima ◽  
Adriana L. Vieira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cortical Stimulation ◽  
Direct Current Stimulation

scholarly journals Transcranial Direct Current Stimulation to Enhance Cognitive Impairment in Parkinson's Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 11 ◽  
Author(s):  
Diana M. A. Suarez-García ◽  
Johan S. Grisales-Cárdenas ◽  
Máximo Zimerman ◽  
Juan F. Cardona
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Cognitive Deficits ◽  
Transcranial Direct Current Stimulation ◽  
Meta Analysis ◽  
Direct Current Stimulation ◽  
Positive Effects ◽  
Cognitive Improvement

Cognitive deficits are increasingly being recognized as a common trait in Parkinson's disease (PD). Recently, transcranial direct current stimulation (tDCS) has been shown to exert positive effects as an adjunctive therapy on motor and non-motor symptoms in PD. This systematic review and meta-analysis aims to provide an overview of reported evidence on the efficacy of tDCS interventions in the treatment of cognitive impairments in PD. A systematic literature review was conducted to examine articles that were published in the past 10 years and that study the effects of tDCS on cognitive deficits in PD patients. The PubMed, Scopus and Scielo databases were searched. Eight tDCS studies involving 168 participants were included for the analysis. Our meta-analysis results showed that anodal tDCS (atDCS) had various levels or no evidence of effectiveness. In the pre-post stimulation analysis, a strong effect was reported for executive functions (pre-post: g = 1.51, Z = 2.41, p = 0.016); non-significant effects were reported for visuospatial skills (pre-post: g = 0.27, Z = 0.69, p = 0.490); attention (pre-post: g = 0.02, Z = 0.08, p = 0.934), memory (pre-post: g = 0.01, Z = 0.03, p = 0.972) and language (pre-post: g = 0.07, Z = 0.21, p = 0.832). However, in the pre-follow-up stimulation analysis, the duration of the effect was not clear. This study highlights the potential effectiveness of atDCS to improve cognitive performance in PD patients but failed to establish a cause-effect relationship between tDCS intervention and cognitive improvement in PD. Future directions and recommendations for methodological improvements are outlined.

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