Transcranial direct current stimulation combined with physical or cognitive training in people with Parkinson's disease: a systematic review

Author(s)

Beretta, Victor Spiandor ^{[1, 2]} ; Conceicao, Nubia Ribeiro ^{[1, 2]} ; Nobrega-Sousa, Priscila ^{[1, 2]} ; Orcioli-Silva, Diego ^{[1, 2]} ; Braz Fonseca Dantas, Luana Karla ^[1] ; Bucken Gobbi, Lilian Teresa ^{[1, 2]} ; Vitorio, Rodrigo ^{[3, 1, 2]}

Affiliation

^[1] Sao Paulo State Univ Unesp, Inst Biosci Posture & Gait Studies Lab LEPLO, Ave 24-A, 1515, BR-13506900 Rio Claro, SP - Brazil

^[2] Sao Paulo State Univ UNESP, Grad Program Movement Sci, Rio Claro, SP - Brazil

^[3] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 - USA

• Document type: Review article
• Source: JOURNAL OF NEUROENGINEERING AND REHABILITATION; v. 17, n. 1 JUN 15 2020.
• Web of Science Citations: 0

Abstract

BackgroundPharmacologic therapy is the primary treatment used to manage Parkinson's disease (PD) symptoms. However, it becomes less effective with time and some symptoms do not respond to medication. Complementary interventions are therefore required for PD. Recent studies have implemented transcranial direct current stimulation (tDCS) in combination with other modalities of interventions, such as physical and cognitive training. Although the combination of tDCS with physical and cognitive training seems promising, the existing studies present mixed results. Therefore, a systematic review of the literature is necessary.AimsThis systematic review aims to (i) assess the clinical effects of tDCS when applied in combination with physical or cognitive therapies in people with PD and; (ii) analyze how specific details of the intervention protocols may relate to findings.MethodsThe search strategy detailed the technique of stimulation, population and combined interventions (i.e. cognitive and/or physical training). Only controlled studies were included.ResultsSeventeen of an initial yield of 408 studies satisfied the criteria. Studies involved small sample sizes. tDCS protocols and characteristics of combined interventions varied. The reviewed studies suggest that synergistic effects may be obtained for cognition, upper limb function, gait/mobility and posture when tDCS is combined with cognitive and/or motor interventions in PD.ConclusionThe reported results encourage further research to better understand the therapeutic utility of tDCS and to inform optimal clinical use in PD. Future studies in this field should focus on determining optimal stimulation parameters and intervention characteristics for maximal benefits in people with PD. (AU)

• FAPESP's process: 14/22308-0 - The effects of Parkinson's disease on electroencephalography recordings during free walking and obstacle crossing
• Grantee: Rodrigo Vitório
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 16/21499-1 - Brain cortical activity during human locomotion: Influence of aging, Parkinson's disease and acute physical exercise
• Grantee: Lilian Teresa Bucken Gobbi
• Support Opportunities: Regular Research Grants
• FAPESP's process: 18/07385-9 - The effect of transcranial direct current stimulation in the postural adjustments under external perturbation in patients with Parkinson's Disease
• Grantee: Victor Spiandor Beretta
• Support Opportunities: Scholarships in Brazil - Doctorate