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- Title
The effects of anodal tDCS over the supplementary motor area on gait initiation in Parkinson’s disease with freezing of gait: a pilot study.
- Authors
Lu, Chiahao; Amundsen Huffmaster, Sommer L.; Tuite, Paul J.; MacKinnon, Colum D.
- Abstract
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 < .01).Conclusions: A single dose of A-tDCS over the SMAs did not improve self-initiated gait in PD and FOG. Alternative approaches using a different dose or cortical target are worthy of exploration since individuals demonstrated the capacity to improve.Significance: Neuromodulation strategies tailored to facilitate SMA activity may be ineffective for the treatment of gait initiation impairment in people with PD and FOG.
- Subjects
PARKINSON'S disease; GAIT in humans; TRANSCRANIAL direct current stimulation; DRUG dosage; BRAIN stimulation; MOTOR ability
- Publication
Journal of Neurology, 2018, Vol 265, Issue 9, p2023
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-018-8953-1