Introduction: Transcranial Direct Current Stimulation (TDCS) is a promising method of non-invasive brain stimulation to modulate cortical activity. It has been studied in many areas to enhance cognition and behavior. It also was demonstrated that tDCS induces cortical excitability changes in the human motor cortex.
The objective of this study was to analyze its possible benefit on Gait disturbances in Advanced Parkinson Disease (PD) such as freezing of gait (FOG), apraxia and balance, which remains difficult to improve with subtalamic and pallidal deep brain stimulation.
Methods: Six PD patients, previously submitted to ablative surgery or DBS, with minor appendicular symptoms and severe gait disorder, underwent anodal TDCS over the leg representation in motor cortex. None had showed improvement of gait after levodopa trial. All patients were kept out of medications for at least 12 hours and submitted to 30’ TDCS. Patients were assessed previously and up to 90 minutes after the stimulation. Outcome measure used Gait and balance scale (GABS) (Appendix B).
Results: Four patients showed improvement of gait following TDCS superior to a 40% reduction in GABS. Two showed excellent response (reduction > 60%) and two moderate improvement of gait after TDCS. Only one patient didn’t responded to the stimulation proposed.
Conclusions: In this pilot study, we observed a possible modulation of gait and balance after non-invasive motor cortex stimulation. TDCS should be investigated as new option in the assessment of gait disturbances in PD.
Patient Care: It might improve mobility and diminishes morbidity in Advanced Parkinson Disease
Learning Objectives: By the conclusion of this session, participants should be able to identify a new tolo in gait management