Multiple Sessions of Transcranial Direct Current Stimulation Combined with Motor Exercises on Postural Control in Individuals with Parkinson's Disease: A Randomized Clinical Trial

• Grant number: 25/00789-0
• Support Opportunities: Scholarships in Brazil - Master
• Start date: July 01, 2025
• End date: August 31, 2026
• Field of knowledge: Health Sciences - Physical Education
• Principal Investigator: Victor Spiandor Beretta
• Grantee: Beatriz Regina Legutke
• Host Institution: Faculdade de Ciências e Tecnologia (FCT). Universidade Estadual Paulista (UNESP). Campus de Presidente Prudente. Presidente Prudente , SP, Brazil

Abstract

Changes in postural control in individuals with Parkinson's disease (PD) are evidenced by increased body sway.Because postural control is poorly responsive to pharmacological treatment, complementary interventions such as transcranial direct current stimulation (tDCS), physical/motor exercise, and combinations of these therapies have been explored. Despite their promising results, controversial results have been found in the literature. Thus, the objective of this randomized clinical trial is to analyze the effect of multiple sessions of tDCS combined with motor exercise on postural control in individuals with PD. Thirty-four individuals with PD will be recruited and distributed into two groups: experimental (EG) and control (CG). The experimental protocol consists of ten sessions of tDCS combined with exercises focused on improving balance and locomotion for both groups. The EG will receive active tDCS (2 mA) for 20 minutes, while the CG will receive placebo tDCS. Stimulation will be applied simultaneously to the primary motor (M1) and prefrontal (PFC) cortices. Static postural control will be assessed using inertial sensors in bipedal and tandem stances. Three 30-second trials for each condition will be performed (6 in total). Dynamic postural control will be analyzed using the Mini-BESTest. In addition, the activity of the motor and prefrontal cortices during static postural control will be assessed by functional near-infrared spectroscopy (fNIRS). Assessments will be performed before, 24 hours after the last session, and one month after the end of the intervention sessions. Two-way ANOVAs with repeated measures and Bonferroni post hoc tests will be used to evaluate the effects of the intervention. (AU)