TY - JOUR
T1 - tDCS application for postural control in Parkinson's disease: Effects are associated with baseline characteristics
AU - Beretta, Victor Spiandor
AU - Orcioli-Silva, Diego
AU - Conceição, Núbia Ribeiro
AU - Nóbrega-Sousa, Priscila
AU - Pereira, Marcelo Pinto
AU - Bucken Gobbi, Lilian Teresa
AU - Vitório, Rodrigo
N1 - Funding information:
The authors thank São Paulo Research Foundation (FAPESP) [grant number #2018/07385-9, #2016/21499-1, #2014/22308-0]; National Council for Scientific and Technological Development (CNPq) [grant number #429549/2018-0, #309045/2017–7]; and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES) [Finance Code 001] for financial support.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Introduction Transcranial direct current stimulation (tDCS) improves postural response to perturbation in patients with Parkinson's disease (PwPD). However, the influence of baseline characteristics such as clinical/cognitive and postural performance on the response to tDCS remains unclear. Objective To investigate whether baseline level of postural control (performance during sham condition) and clinical/cognitive characteristics are associated with tDCS-related changes in postural responses to external perturbations in PwPD. Methods Twenty-four PwPD participated in this study. Clinical assessment included disease severity, disease duration, levodopa equivalent dose and global cognition. Anodal tDCS protocols targeting the primary motor cortex were applied in two separate sessions (at least 2 weeks apart): active (2 mA for 20 min) and sham stimulation. Seven trials with the backward translation of the support base (20 cm/s and 5 cm) were performed after tDCS. Postural outcomes included the recovery time to stable position and onset latency of the medial gastrocnemius (MG). Pearson and Spearman correlation tests were performed. Results No significant correlations were observed between clinical/cognitive characteristics and tDCS-related changes in postural responses. Negative associations were observed between the baseline level of postural control and tDCS-related changes in postural responses for the recovery time (r = −0.657; p < 0.001) and the MG onset latency (rs = −0.539; p = 0.007). PwPD with worse baseline postural control demonstrated greater improvement after active stimulation. Conclusions Findings suggest that tDCS-related effects on postural response to perturbation are related to the baseline level of postural control, but not to clinical characteristics in PwPD. Those with worse baseline postural control responded better to tDCS.
AB - Introduction Transcranial direct current stimulation (tDCS) improves postural response to perturbation in patients with Parkinson's disease (PwPD). However, the influence of baseline characteristics such as clinical/cognitive and postural performance on the response to tDCS remains unclear. Objective To investigate whether baseline level of postural control (performance during sham condition) and clinical/cognitive characteristics are associated with tDCS-related changes in postural responses to external perturbations in PwPD. Methods Twenty-four PwPD participated in this study. Clinical assessment included disease severity, disease duration, levodopa equivalent dose and global cognition. Anodal tDCS protocols targeting the primary motor cortex were applied in two separate sessions (at least 2 weeks apart): active (2 mA for 20 min) and sham stimulation. Seven trials with the backward translation of the support base (20 cm/s and 5 cm) were performed after tDCS. Postural outcomes included the recovery time to stable position and onset latency of the medial gastrocnemius (MG). Pearson and Spearman correlation tests were performed. Results No significant correlations were observed between clinical/cognitive characteristics and tDCS-related changes in postural responses. Negative associations were observed between the baseline level of postural control and tDCS-related changes in postural responses for the recovery time (r = −0.657; p < 0.001) and the MG onset latency (rs = −0.539; p = 0.007). PwPD with worse baseline postural control demonstrated greater improvement after active stimulation. Conclusions Findings suggest that tDCS-related effects on postural response to perturbation are related to the baseline level of postural control, but not to clinical characteristics in PwPD. Those with worse baseline postural control responded better to tDCS.
KW - Center of pressure
KW - Electromyography
KW - Movement disorders
KW - Neurodegenerative disease
KW - Non-invasive brain stimulation
KW - Postural balance
UR - http://www.scopus.com/inward/record.url?scp=85119299439&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2021.11.012
DO - 10.1016/j.parkreldis.2021.11.012
M3 - Article
SN - 1353-8020
VL - 93
SP - 62
EP - 65
JO - Parkinsonism & Related Disorders
JF - Parkinsonism & Related Disorders
ER -