The effect of transcranial direct current stimulation in the postural adjustments under external perturbation in patients with Parkinson's Disease

• Grant number: 18/07385-9
• Support Opportunities: Scholarships in Brazil - Doctorate
• Effective date (Start): November 01, 2018
• Effective date (End): February 28, 2022
• Field of knowledge: Health Sciences - Physical Education
• Principal Investigator: Lilian Teresa Bucken Gobbi
• Grantee: Victor Spiandor Beretta
• Host Institution: Instituto de Biociências (IB). Universidade Estadual Paulista (UNESP). Campus de Rio Claro. Rio Claro , SP, Brazil
• Associated scholarship(s): 19/23721-1 - Effect of vibrotactile cueing when turning on prefrontal cortex activity in patients with and without freezing of gait, BE.EP.DR

Abstract

Posture maintenance employs predictive and reactive mechanisms. People with Parkinson's Disease (PD) have difficulty in controlling posture and habituating to external perturbation, due to the deficits in the processing performed in brain structures involved in motor control, such as basal ganglia, Supplementary Motor Area (SMA), primary motor (M1) and pre-frontal cortices. Postural control is not responsive to the pharmacological treatment of PD and, therefore, other forms of treatment have been explored, such as transcranial Direct Current Stimulation (tDCS). However, little is known about the acute and chronic effects of tDCS in people with PD in situations with external perturbation. The aims of this thesis are: (i) to investigate the acute effect of tDCS applied using different intensities (study 1) and (ii) to investigate the effects of 4 and 8 tDCS sessions on predictive and reactive postural adjustments under external perturbation in people with PD (study 2). Thirty people with PD will participate in both studies. In study 1 (crossover, randomized and sham-controlled), the individuals will receive anodal tDCS in the primary motor cortex with intensity of 1mA, 2mA and sham (on 3 different days) with duration of 20 min. Seven trials (after the tDCS on each moment/day) will be performed with unpredictable postural perturbation applied by the posterior displacement of the support base. In study 2, the intervention with chronic tDCS will be performed in 8 sessions where 15 patients will receive real anodal tDCS (PDR) and other 15 patients will receive sham stimulation (CG-control group); the intensity of stimulation will be determined from the results of study 1. The evaluations will be carried out in the pre-intervention moments, after 4 and 8 sessions and after 1 month of the end of the intervention (follow up), with 7 trials with external perturbation. The EMG, Center of Pressure (CoP) and cortical activity parameters in predictive and reactive postural adjustments will be analyzed. Statistical analyzes will be employed to verify the differences between intensities and trials (habituation) in study 1, and between groups and moments in study 2. (AU)

Scientific publications

(5)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

LEGUTKE, BEATRIZ REGINA; GOBBI, LILIAN TERESA BUCKEN; ORCIOLI-SILVA, DIEGO; DOS SANTOS, PAULO CEZAR ROCHA; MORACA, GABRIEL ANTONIO GAZZIERO; VITORIO, RODRIGO; BERETTA, VICTOR SPIANDOR. Transcranial direct current stimulation suggests not improving postural control during adapted tandem position in people with Parkinson's disease: A pilot study. Behavioural Brain Research, v. 452, p. 8-pg., 2023-07-15. (18/07385-9, 20/12656-1)

BERETTA, VICTOR SPIANDOR; ORCIOLI-SILVA, DIEGO; CONCEICA, NUBIA RIBEIRO; NOBREGA-SOUSA, PRISCILA; PEREIRA, SOUSA A MARCELO PINTO; GOBBI, LILIAN TERESA BUCKEN; VITORIO, RODRIGO. tDCS application for postural control in Parkinson's disease: Effects are associated with baseline characteristics. PARKINSONISM & RELATED DISORDERS, v. 93, p. 62-65, DEC 2021. (14/22308-0, 18/07385-9, 16/21499-1)

BERETTA, VICTOR SPIANDOR; CONCEICAO, NUBIA RIBEIRO; NOBREGA-SOUSA, PRISCILA; ORCIOLI-SILVA, DIEGO; BRAZ FONSECA DANTAS, LUANA KARLA; BUCKEN GOBBI, LILIAN TERESA; VITORIO, RODRIGO. Transcranial direct current stimulation combined with physical or cognitive training in people with Parkinson's disease: a systematic review. JOURNAL OF NEUROENGINEERING AND REHABILITATION, v. 17, n. 1, JUN 15 2020. (14/22308-0, 16/21499-1, 18/07385-9)

BERETTA, VICTOR SPIANDOR; SANTOS, PAULO CEZAR ROCHA; ORCIOLI-SILVA, DIEGO; ZAMPIER, VINICIUS CAVASSANO; VITORIO, RODRIGO; GOBBI, LILIAN TERESA BUCKEN. Transcranial direct current stimulation for balance rehabilitation in neurological disorders: A systematic review and meta-analysis. AGEING RESEARCH REVIEWS, v. 81, p. 22-pg., 2022-11-01. (18/07385-9)

BERETTA, VICTOR SPIANDOR; VITORIO, RODRIGO; NOBREGA-SOUSA, PRISCILA; CONCEICAO, NUBIA RIBEIRO; ORCIOLI-SILVA, DIEGO; PEREIRA, MARCELO PINTO; BUCKEN GOBBI, LILIAN TERESA. Effect of Different Intensities of Transcranial Direct Current Stimulation on Postural Response to External Perturbation in Patients With Parkinson's Disease. NEUROREHABILITATION AND NEURAL REPAIR, v. 34, n. 11, p. 11-pg., 2020-10-01. (18/07385-9, 16/21499-1, 14/22308-0)

Academic Publications

(References retrieved automatically from State of São Paulo Research Institutions)

BERETTA, Victor Spiandor. Effectiveness of transcranial direct current stimulation on postural adjustments under external perturbations in patients with Parkinson's disease. 2022. Doctoral Thesis - Universidade Estadual Paulista (Unesp). Instituto de Biociências. Rio Claro Rio Claro.