scholarly journals The Effect of Transcranial Direct Current Stimulation and Core Stability Training on the Balance and Disability of Patients With Multiple Sclerosis

2021 ◽  
Vol 11 (3) ◽  
pp. 189-198
Author(s):  
Soudabeh Raeisi ◽  
◽  
Seyed Kazem Mousavi Sadati ◽  
Mojtaba Azimian ◽  
◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Postural Control ◽  
Direct Current ◽  
Vestibular System ◽  
Transcranial Direct Current Stimulation ◽  
Core Stability ◽  
Direct Current Stimulation ◽  
Cerebellar Tdcs ◽  
Stability Training ◽  
Sensory Condition

Purpose: Physicians report balance disorders and fatigue as the symptoms of Multiple Sclerosis (MS) disease. The present study compares the effect of transcranial Direct Current Stimulation (tDCS) and core stability training on the balance and disability of patients with MS. Methods: This is a pre-test, post-test experiment study. The statistical population included all patients with MS who reffered to Rofaydeh Rehabilitation Hospital in Tehran City, Iran, in the winter of 2019. A total of 30 male and female patients aged 27-70 years were selected through available and purposive sampling methods and then randomly divided into experimental and control groups (each group 15 persons). The initial measurements of the participants’ kinetic variables of postural control were carried out by the posturography device, and afterward, Kurtzke Expanded Disability Status Scale (EDSS) was employed to measure disability. The participants’ training included core stability training for 8 weeks (30-40 min, 3 sessions per week) with 20 min online cerebellar transcranial direct current stimulation, 2 sessions per week (The first and third sessions). Then, the research variables were measured again. Results: The results demonstrated the significant influence of cerebellar tDCS on the variables of postural control equilibrium in the second sensory condition (P<0.001), third sensory condition (P<0.001), fourth sensory condition (P<0.001), fifth sensory condition (P=0.034), and combine equilibrium (P<0.001). Besides, the cerebellar current stimulation enhanced the sensory performance of the experimental group in using the vestibular system input data (P<0.001) and vision (P<0.001), but it had no significant effect on the ability to use somatosensory input (P=0.203) and vision preference (P=0.343). This research also revealed that the cerebellar current stimulation decreased EDSS in MS patients (P=0.026). Conclusion: The cerebellar tDCS has a beneficial effect on balance, EDSS, and modified fatigue impact scale in MS patients. The study findings also indicate that the cerebellum, vestibular system, and visual system are related, and they have an impact on balance, and cerebellar stimulation can facilitate learning motor skills.

scholarly journals Transcranial direct current stimulation of cerebellum alters spiking precision in cerebellar cortex: A modeling study of cellular responses

2021 ◽  
Vol 17 (12) ◽  
pp. e1009609
Author(s):  
Xu Zhang ◽  
Roeland Hancock ◽  
Sabato Santaniello
Keyword(s):  
Purkinje Cells ◽  
Cerebellar Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cellular Response ◽  
Cerebellar Neurons ◽  
Direct Current Stimulation ◽  
Repolarization Phase ◽  
Cerebellar Tdcs ◽  
Complex Spikes

Transcranial direct current stimulation (tDCS) of the cerebellum has rapidly raised interest but the effects of tDCS on cerebellar neurons remain unclear. Assessing the cellular response to tDCS is challenging because of the uneven, highly stratified cytoarchitecture of the cerebellum, within which cellular morphologies, physiological properties, and function vary largely across several types of neurons. In this study, we combine MRI-based segmentation of the cerebellum and a finite element model of the tDCS-induced electric field (EF) inside the cerebellum to determine the field imposed on the cerebellar neurons throughout the region. We then pair the EF with multicompartment models of the Purkinje cell (PC), deep cerebellar neuron (DCN), and granule cell (GrC) and quantify the acute response of these neurons under various orientations, physiological conditions, and sequences of presynaptic stimuli. We show that cerebellar tDCS significantly modulates the postsynaptic spiking precision of the PC, which is expressed as a change in the spike count and timing in response to presynaptic stimuli. tDCS has modest effects, instead, on the PC tonic firing at rest and on the postsynaptic activity of DCN and GrC. In Purkinje cells, anodal tDCS shortens the repolarization phase following complex spikes (-14.7 ± 6.5% of baseline value, mean ± S.D.; max: -22.7%) and promotes burstiness with longer bursts compared to resting conditions. Cathodal tDCS, instead, promotes irregular spiking by enhancing somatic excitability and significantly prolongs the repolarization after complex spikes compared to baseline (+37.0 ± 28.9%, mean ± S.D.; max: +84.3%). tDCS-induced changes to the repolarization phase and firing pattern exceed 10% of the baseline values in Purkinje cells covering up to 20% of the cerebellar cortex, with the effects being distributed along the EF direction and concentrated in the area under the electrode over the cerebellum. Altogether, the acute effects of tDCS on cerebellum mainly focus on Purkinje cells and modulate the precision of the response to synaptic stimuli, thus having the largest impact when the cerebellar cortex is active. Since the spatiotemporal precision of the PC spiking is critical to learning and coordination, our results suggest cerebellar tDCS as a viable therapeutic option for disorders involving cerebellar hyperactivity such as ataxia.

Bifrontal transcranial direct current stimulation modulates fatigue in multiple sclerosis: a randomized sham-controlled study

2020 ◽  
Vol 127 (6) ◽  
pp. 953-961 ◽  
Author(s):  
Moussa A. Chalah ◽  
Christina Grigorescu ◽  
Frank Padberg ◽  
Tania Kümpfel ◽  
Ulrich Palm ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Controlled Study ◽  
Direct Current Stimulation

Power spectral parameter variations after transcranial direct current stimulation in a bimanual coordination task

2019 ◽  
pp. 105971231987997 ◽  
Author(s):  
Atefeh Azarpaikan ◽  
HamidReza Taherii Torbati ◽  
Mehdi Sohrabi ◽  
Reza Boostani ◽  
Majid Ghoshuni
Keyword(s):  
Parietal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Bimanual Coordination ◽  
Neuronal Membrane ◽  
Membrane Excitability ◽  
Direct Current Stimulation ◽  
Cerebellar Tdcs ◽  
Alpha Beta ◽  
The Brain

Transcranial direct current stimulation (tDCS) can shift neuronal membrane excitability by applying a weak slow electric current to the brain through the scalp. Attendant electroencephalography (EEG) can provide valuable information about the tDCS mechanisms. This study investigated the effects of anodal tDCS on parietal cortex and cerebellum activity to reveal possible modulation of spontaneous oscillatory brain activity. Timing of the tDCS priming protocol in relation to the intervention especially with respect to bimanual coordination task was also studied. EEG activity was measured in 120 healthy participants before and after sessions of anodal stimulation of the parietal cortex and cerebellum to detect the tDCS-induced alterations. Variations of the delta, theta, alpha, beta, and sensorimotor rhythm (SMR) power bands were analyzed using a MATLAB program. The results showed that anodal parietal and cerebellar tDCS cause changes in brain wave frequencies. They also showed an increase in alpha, beta, and SMR power bands during stimulation sessions for during stimulation parietal group ( p ≤ .01). Also, theta, alpha, beta, and SMR power bands were increased in during stimulation cerebellum group in stimulation sessions and 48 h later ( p ≤ .01). Moreover, the results revealed that the tDCS intervention led to a variety of activations in some areas of the brain. Altogether, the cerebellar tDCS during motor task had a significant improvement in off-line learning.

scholarly journals Cerebellar Transcranial Direct Current Stimulation in People with Parkinson’s Disease: A Pilot Study

2020 ◽  
Vol 10 (2) ◽  
pp. 96 ◽  
Author(s):  
Craig D. Workman ◽  
Alexandra C. Fietsam ◽  
Ergun Y. Uc ◽  
Thorsten Rudroff
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Berg Balance Scale ◽  
Preliminary Evidence ◽  
Balance Performance ◽  
Direct Current Stimulation ◽  
Limited Effectiveness ◽  
Cerebellar Tdcs

People with Parkinson’s disease (PwPD) often experience gait and balance problems that substantially impact their quality of life. Pharmacological, surgical, and rehabilitative treatments have limited effectiveness and many PwPD continue to experience gait and balance impairment. Transcranial direct current stimulation (tDCS) may represent a viable therapeutic adjunct. The effects of lower intensity tDCS (2 mA) over frontal brain areas, in unilateral and bilateral montages, has previously been explored; however, the effects of lower and higher intensity cerebellar tDCS (2 mA and 4 mA, respectively) on gait and balance has not been investigated. Seven PwPD underwent five cerebellar tDCS conditions (sham, unilateral 2 mA, bilateral 2 mA, unilateral 4 mA, and bilateral 4 mA) for 20 min. After a 10 min rest, gait and balance were tested. The results indicated that the bilateral 4 mA cerebellar tDCS condition had a significantly higher Berg Balance Scale score compared to sham. This study provides preliminary evidence that a single session of tDCS over the cerebellum, using a bilateral configuration at a higher intensity (4 mA), significantly improved balance performance. This intensity and cerebellar configuration warrants future investigation in larger samples and over repeated sessions.

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