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The effects of anodal tDCS over the supplementary motor area on gait initiation in Parkinson’s disease with freezing of gait: a pilot study

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Abstract

Objective

We investigated if anodal transcranial direct current stimulation (A-tDCS), applied over the supplementary motor areas (SMAs), could improve gait initiation in Parkinson’s disease (PD) with freezing of gait (FOG).

Methods

In this double-blinded cross-over pilot study, ten PD with FOG underwent two stimulation sessions: A-tDCS (1 mA, 10 min) and sham stimulation. Eight blocks of gait initiation were collected per session: (1) pre-tDCS, with acoustic cueing; (2) pre-tDCS, self-initiated (no cue); and (3–8) post-tDCS, self-initiated. Gait initiation kinetics were analyzed with two-way repeated measures ANOVAs for the effects of A-tDCS.

Results

A-tDCS did not significantly improve the magnitude or timing of anticipatory postural adjustments or the execution of the first step during self-initiated gait compared with baseline measures (p > .13). The lack of significant change was not due to an inability to generate functional APAs since external cueing markedly improved gait initiation (p < .01).

Conclusions

A single dose of A-tDCS over the SMAs did not improve self-initiated gait in PD and FOG. Alternative approaches using a different dose or cortical target are worthy of exploration since individuals demonstrated the capacity to improve.

Significance

Neuromodulation strategies tailored to facilitate SMA activity may be ineffective for the treatment of gait initiation impairment in people with PD and FOG.

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Acknowledgements

This work was supported by the National Institute of Neurological Disorders and Stroke at the National Institutes of Health [Grant numbers R01 NS070264; R01 NS085188 and P50 NS098573]; the University of Minnesota Neuromodulation Innovations (MnDRIVE) and the National Center for Advancing Translational Sciences of the National Institutes of Health [grant number UL1TR000114]. We are grateful to Bradley Baker, Kyle Ballard, Christina Barth, and Annabel Bavage for their assistance in data post-processing, and our clinical research coordinators, Jacqueline Vachon and Joshua De Kam.

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Authors and Affiliations

  1. Department of Neurology, University of Minnesota, Minneapolis, MN, 55414, USA

    Chiahao Lu, Sommer L. Amundsen Huffmaster, Paul J. Tuite & Colum D. MacKinnon

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  1. Chiahao Lu
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  2. Sommer L. Amundsen Huffmaster
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  3. Paul J. Tuite
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Correspondence to Chiahao Lu.

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Preliminary findings from this study were presented in abstract form at the Society for Neuroscience Meeting in 2015

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Lu, C., Amundsen Huffmaster, S.L., Tuite, P.J. et al. The effects of anodal tDCS over the supplementary motor area on gait initiation in Parkinson’s disease with freezing of gait: a pilot study. J Neurol 265, 2023–2032 (2018). https://doi.org/10.1007/s00415-018-8953-1

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  • DOI: https://doi.org/10.1007/s00415-018-8953-1

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