TY - JOUR
T1 - Effects of DLPFC tDCS Followed by Treadmill Training on Dual-Task Gait and Cortical Excitability in Parkinson’s Disease
T2 - A Randomized Controlled Trial
AU - Wong, Pei Ling
AU - Yang, Yea Ru
AU - Huang, Shih Fong
AU - Wang, Ray Yau
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/9
Y1 - 2024/9
N2 - Background: Gait disturbances are exacerbated in people with Parkinson’s disease (PD) during dual-task walking (DTW). Transcranial direct current stimulation (tDCS) has been shown to exert beneficial effects on gait performance and cortical excitability in PD; however, its combined effects with treadmill training (TT) remain undetermined. Objective: To investigate the effects of tDCS followed by TT on DTW performance and cortical excitability in individuals with PD. Methods: Thirty-four PD participants were randomized to dorsal lateral prefrontal cortex (DLPFC) tDCS and TT group (DLPFC tDCS + TT group) or sham tDCS and TT group (sham tDCS + TT group) for 50 minutes per session (20 minutes tDCS followed by 30 minutes TT), 12 sessions within 5 weeks (2-3 sessions each week). Outcome measures included cognitive dual-task walking (CDTW), motor dual-task walking (MDTW), usual walking performance, cortical excitability, functional mobility, cognitive function, and quality of life. Results: The DLPFC tDCS + TT group exerted significantly greater improvement in CDTW velocity (P =.046), cadence (P =.043), and stride time (P =.041) compared to sham tDCS + TT group. In addition, DLPFC tDCS + TT group demonstrated a significant increase in resting motor threshold of stimulated hemisphere compared with sham tDCS + TT group (P =.026). However, no significant differences between groups were found in MDTW performance and other outcomes. Conclusion: Twelve-session DLPFC tDCS followed by TT significantly improved CDTW performance and decreased cortical excitability more than TT alone in individuals with PD. Applying DLPFC tDCS prior to TT could be suggested for gait rehabilitation in individuals with PD. Clinical trial registration number: Australian New Zealand Clinical Trials Registry ACTRN12622000101785.
AB - Background: Gait disturbances are exacerbated in people with Parkinson’s disease (PD) during dual-task walking (DTW). Transcranial direct current stimulation (tDCS) has been shown to exert beneficial effects on gait performance and cortical excitability in PD; however, its combined effects with treadmill training (TT) remain undetermined. Objective: To investigate the effects of tDCS followed by TT on DTW performance and cortical excitability in individuals with PD. Methods: Thirty-four PD participants were randomized to dorsal lateral prefrontal cortex (DLPFC) tDCS and TT group (DLPFC tDCS + TT group) or sham tDCS and TT group (sham tDCS + TT group) for 50 minutes per session (20 minutes tDCS followed by 30 minutes TT), 12 sessions within 5 weeks (2-3 sessions each week). Outcome measures included cognitive dual-task walking (CDTW), motor dual-task walking (MDTW), usual walking performance, cortical excitability, functional mobility, cognitive function, and quality of life. Results: The DLPFC tDCS + TT group exerted significantly greater improvement in CDTW velocity (P =.046), cadence (P =.043), and stride time (P =.041) compared to sham tDCS + TT group. In addition, DLPFC tDCS + TT group demonstrated a significant increase in resting motor threshold of stimulated hemisphere compared with sham tDCS + TT group (P =.026). However, no significant differences between groups were found in MDTW performance and other outcomes. Conclusion: Twelve-session DLPFC tDCS followed by TT significantly improved CDTW performance and decreased cortical excitability more than TT alone in individuals with PD. Applying DLPFC tDCS prior to TT could be suggested for gait rehabilitation in individuals with PD. Clinical trial registration number: Australian New Zealand Clinical Trials Registry ACTRN12622000101785.
KW - cortical excitability
KW - dual-task walking
KW - Parkinson’s disease
KW - transcranial direct current stimulation
KW - treadmill training
UR - http://www.scopus.com/inward/record.url?scp=85200673720&partnerID=8YFLogxK
U2 - 10.1177/15459683241268583
DO - 10.1177/15459683241268583
M3 - Article
C2 - 39104216
AN - SCOPUS:85200673720
SN - 1545-9683
VL - 38
SP - 680
EP - 692
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
IS - 9
ER -