The effects of anodal tDCS over the supplementary motor area on gait initiation in Parkinson’s disease with freezing of gait: a pilot study

Objective We investigated if anodal transcranial direct current stimulation (A-tDCS), applied over the supplementary motor areas (SMAs), could improve gait initiation in Parkinson’s disease (PD) with freezing of gait (FOG). Methods In this double-blinded cross-over pilot study, ten PD with FOG under...

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Bibliographic Details
Published in:Journal of neurology 2018-09, Vol.265 (9), p.2023-2032
Main Authors: Lu, Chiahao, Amundsen Huffmaster, Sommer L., Tuite, Paul J., MacKinnon, Colum D.
Format: Article
Language:English
Subjects:
Aged
Biomechanical Phenomena
Cortex
Cross-Over Studies
Double-Blind Method
Electrical stimulation of the brain
ESB
Exploration
Female
Gait
Gait Disorders, Neurologic - physiopathology
Gait Disorders, Neurologic - therapy
Humans
Male
Medicine
Medicine & Public Health
Motor Cortex - physiopathology
Movement disorders
Neurodegenerative diseases
Neurology
Neuromodulation
Neuroradiology
Neurosciences
Original Communication
Parkinson Disease - physiopathology
Parkinson Disease - therapy
Parkinson's disease
Pilot Projects
Posture
Supplementary motor area
Transcranial Direct Current Stimulation - methods
Treatment Failure
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Summary:Objective We investigated if anodal transcranial direct current stimulation (A-tDCS), applied over the supplementary motor areas (SMAs), could improve gait initiation in Parkinson’s disease (PD) with freezing of gait (FOG). Methods In this double-blinded cross-over pilot study, ten PD with FOG underwent two stimulation sessions: A-tDCS (1 mA, 10 min) and sham stimulation. Eight blocks of gait initiation were collected per session: (1) pre-tDCS, with acoustic cueing; (2) pre-tDCS, self-initiated (no cue); and (3–8) post-tDCS, self-initiated. Gait initiation kinetics were analyzed with two-way repeated measures ANOVAs for the effects of A-tDCS. Results A-tDCS did not significantly improve the magnitude or timing of anticipatory postural adjustments or the execution of the first step during self-initiated gait compared with baseline measures ( p  > .13). The lack of significant change was not due to an inability to generate functional APAs since external cueing markedly improved gait initiation ( p  
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-018-8953-1