None listed
Conditions
Brief summary
Parkinson’s disease (PD) is a progressive disease, and is characterized by disabling movement problem including, gait difficulties and balance impairment. These affect activities of daily living, quality of life and increase the risk of falls that in turn lead to hospitalization and mortality. Gait difficulties and balance impairment are devastating problems in people with PD and continue to be an important topic for health professionals and scientists. Treatment for PD drug treatment as the first line of treatment and surgery for advanced stages. While surgical and pharmacological approaches to the treatment of PD can help to partially improve some gait difficulties, they do not always result in improvements. Allied health treatments are also used in treatment of PD. However, there is no firm consensus on the efficacy of these treatments. This suggests a need for additional and complementary approaches to manage gait and balance difficulties in PD. Recently transcranial direct current stimulation (tDCS) has been used extensively in neuroscience research. It has been used to improve movement and recovery in stroke and other neurologic disorders. It is considered to be safe with no serious adverse effects. Consequently this has raised interest in using tDCS as an intervention to improve movement in PD. This study proposes to undertake a randomized controlled study to investigate whether tDCS is effective in improving gait and balance in people with PD. If it is proved to be effective it may provide an alternative intervention strategy for treatment of movement complications of people with PD which hopefully could lead to improved quality of life and functional status.
Interventions
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation approach now widely used in neuroscientific and clinical research in humans It has an excellent safety profile and is a low cost technique that is easy to administer in double-blind clinical trials. TDCS modulates cortical excitability via a weak direct current that is delivered by two or more scalp affixed electrodes. Anodal tDCS (a-tDCs) increases cortical excitability and cathodal tDCS (c-tDCs) decreases it. Th
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation approach now widely used in neuroscientific and clinical research in humans It has an excellent safety profile and is a low cost technique that is easy to administer in double-blind clinical trials. TDCS modulates cortical excitability via a weak direct current that is delivered by two or more scalp affixed electrodes. Anodal tDCS (a-tDCs) increases cortical excitability and cathodal tDCS (c-tDCs) decreases it. The underlying mechanisms by which tDCS modulates neurophysiology and behaviour are not yet fully understood. However, it is thought that acute effects of a single session of 20 second tDCS last for at least 24 hours. Further, the effects of 5-10 sessions of tDCS play a key role in neuroplasticity underlying adaptive human behaviour and learning. In this study, tDCS will be delivered using a battery driven NeuroConn DC stimulator. A trained researcher (the PhD student) will deliver the brain stimulation in three face-to face sessions at Institute of Health and Biomedical Innovation at Queensland University of Technology. Each participant will undergo active a-tDCS and sham-tDCS (placebo) over three sessions with two weeks interval to minimize carry-over effects. A central anode electrode will be placed over the motor strip during treadmill walking in all three sessions. Two cathode electrodes (either 10×10/4×4 cm2) will be placed over the cerebellum. The order of the cathode electrodes in two active tDCS sessions will be counterbalanced across the participants. Thus, one third of the participants will receive active tDCS with a large cathode first; and another one third of the participants will receive active tDCS with a small cathode electrode firs; the final third of the participants will receive a sham-tDCS (placebo) with either a small or large cathode electrode. In sham condition, 50% of participants will have a large cathode electrode and 50% will have a small cathode electrode. Electrodes will be inserted in saline-soaked sponge electrodes. An EASY-cap and a strap will be used to attach the electrodes over the target locations. The current will be increased to 1mA over 10 sec, held constant at 1 mA for 20 minutes and then decreased over 10 sec at the end of the stimulation. During administration of tDCS all participants will be asked to walk on treadmill (Nautilus treadmill) for 20 minutes at their self-selected comfortable speed. The severity of adverse effects will be assessed using a scale suggested by Brunoni et al. after each tDCS session.
Sponsors
Queensland University of Technology
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
40 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria for the participants with Parkinson's diseases (PD): 1) Having diagnosis of Parkinson's 2) Walking independently for 10-15 minutes
Exclusion criteria
Being pregnant Taking any psychoactive medications Having: an adverse reaction to TMS/tDCS, seizure, vision impairment, vertigo, frequent falls, dizziness, any brain related neurological illness other than PD, uncontrolled blood pressure (hypotension or hypertension), any musculoskeletal disorders, functional limitations associated with osteoporosis, orthopaedic surgery within the last 12 months, brain surgery, metal implants in the head, any implanted medical device, any epileptic family members, migraines or neural trauma, unexplained loss of consciousness, serious head injury, surgery to the head, and frequent or severe headache.
Outcome results
None listed