Research project: Does transcranial Direct Current Stimulation improve functional mobility in people with Parkinson's disease?
Can non-invasive brain stimulation improve moving, turning and walking in people with Parkinson's disease?
Can non-invasive brain stimulation improve moving, turning and walking in people with Parkinson's disease?
An innovative and potentially promising way of enhancing standard rehabilitation has emerged in recent years and is called transcranial direct current stimulation. This is a painless and non-invasive form of brain stimulation; two electrodes are placed on the head for 15 minutes of stimulation. We wish to test the potential of this method to improve the way people with PD move around in everyday life. To date, only one group of researchers have used this method and they showed an improvement in the movements of people with PD.
We propose to further investigate this technique; we will measure standing up from sitting, turning and walking before and after brain stimulation. We will test people who are in either the earlier or later stage of PD and we will look at differences between the way they move during their best and worse times in between taking medication. We would like to include 20 people with PD who will be invited to visiting Southampton General Hospital on four occasions (approximately 2 hours once every week for four weeks). We need to evaluate the technique in order to understand the potential for enhancing the current treatment of people with PD. Established motor treatment such as physiotherapy could be complemented by this form of brain stimulation to further improve the quality of moving, turning and walking in PD.
Verheyden G, Ashburn A, Cole J.
Transcranial Direct Current Stimulation (tDCS) is a painless form of non-invasive brain stimulation whereby low amplitude direct currents are applied to the brain via scalp electrodes. tDCS can modulate cortical excitability and function beyond the stimulation period, and one promising study in people with Parkinson’s disease (PD) showed significant improvements in UPDRS motor score after tDCS stimulation.
To examine if tDCS improves functional mobility in people with PD. We want to investigate if the effect of tDCS is influenced by disease severity and the medication cycle.
We propose a double-blind, observational cross-over study. Participants will be recruited from local PD Society branches in Hampshire and will be invited to our Movement Laboratory on four occasions (two times in the ON and two times in the OFF phase), participants will be stratified by early and late stages of PD and they will be stimulated in the ON and OFF phases of the medication cycle. In each of these phases, participants will receive tDCS active stimulation on one occasion and sham stimulation on the other. Medication cycle (ON/OFF) and tDCS stimulation (active/sham) will be pseudo randomised. Participants will be assessed with the functional reach, standing start 180 degrees turn test, and timed Up and Go test before, during and after tDCS stimulation.
tDCS is an innovative, promising and easy method for neuromodulation and more studies are needed. This study could pump-prime research and guide the methodology of a future pilot clinical trial.