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 type: Scholarships in Brazil - Doctorate
• Effective date (Start): November 01, 2018
• Effective date (End): February 28, 2022
• Field of knowledge: Health Sciences - Physical Education
• Principal researcher: Lilian Teresa Bucken Gobbi
• Grantee: Victor Spiandor Beretta
• Home 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

(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)

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. Web of Science Citations: 0.