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

Vida Alizad, Marcus Meinzer, Laurent Frossard, Remco Polman, Simon Smith, Graham Kerr

Journal: Trials 2019;19(1):661

PMID: 30486849

Free Full Text on BioMed Central View on PubMed

Abstract

BACKGROUND

Gait 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.

METHODS

This 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 cm) 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 cm); anodal tDCS with a large, functionally inert cathode (10 × 10 cm); 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.

DISCUSSION

This 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 REGISTRATION

Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618000063213 . Registered on 17 January 2018. Retrospectively registered.

Address: Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia. [email protected].; Iranian Research Centre on Ageing, The University of Social Welfare and rehabilitation Sciences, Tehran, Iran. [email protected].; Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.; Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, QLD, Australia.; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.; Institute for Social Science Research (ISSR), The University of Queensland, Brisbane, QLD, Australia.; Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.

DOI: 10.1186/s13063-018-2982-z

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/parkinsonsdisease.html

MeSH Terms: Adult, Aged, Aged, 80 and over, Cross-Over Studies, Double-Blind Method, Electromyography, Female, Gait, Gait Analysis, Humans, Male, Middle Aged, Motor Cortex, Parkinson Disease, Queensland, Randomized Controlled Trials as Topic, Recovery of Function, Time Factors, Transcranial Direct Current Stimulation, Treatment Outcome