Transcranial Stimulation Plus Exercise Improves Gait in Parkinson Disease

Adding anodal transcranial direct current stimulation (tDCS) to aerobic exercise improved gait in people with Parkinson disease in a double-blind, sham-controlled crossover study. Researchers published their findings in Neurorehabilitation & Neural Repair.

“Despite the limitations of such a small sample size, we found that transcranial stimulation activated the prefrontal cortex, a brain region that Parkinson patients use more to control gait than healthy individuals,” said researcher Rodrigo Vitório, PhD, a professor at São Paulo State University’s Institute of Biosciences in Brazil. “A single session associated with exercise enhanced cognitive function and produced other improvements.”

For the study, patients completed a 30-minute session of moderate-intensity cycling combined with either active tDCS targeting the prefrontal cortex or sham-tDCS. The following week, patients received the alternative intervention.

The administration of tDCS involves two small electrodes attached to specific areas of the head and a portable, battery-powered appliance. At 2 milliamperes, the current is weak yet sufficient to stimulate nearby neurons, researchers explained.

After aerobic exercise combined with active tDCS, participants demonstrated decreased step time variability, shortened reaction times, and increased prefrontal activity in the stimulated hemisphere while walking, the study found. The effects were not seen with exercise and sham-tDCS.

“The addition of anodal tDCS over the prefrontal cortex to a session of aerobic exercise led to immediate positive effects on gait variability, processing speed, and executive control of walking in people with Parkinson disease,” researchers concluded.

References:

Conceição NR, Gobbi LTB, Nóbrega-Sousa P, et al. Aerobic Exercise Combined With Transcranial Direct Current Stimulation Over the Prefrontal Cortex in Parkinson Disease: Effects on Cortical Activity, Gait, and Cognition. Neurorehabil Neural Repair. 2021;35(8):717-728. doi:10.1177/15459683211019344

Transcranial stimulation enhances beneficial effect of aerobic exercise on gait in Parkinson’s patients. News release. Fundação de Amparo à Pesquisa do Estado de São Paulo; August 24, 2021.