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

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

doi:10.1007/s00415-018-8953-1

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

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

Neurology

Research output: Contribution to journal › Article › peer-review

28 Scopus citations

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.

Original language	English (US)
Pages (from-to)	1-10
Number of pages	10
Journal	Journal of Neurology
Volume	265
Issue number	9
DOIs	https://doi.org/10.1007/s00415-018-8953-1
State	Accepted/In press - Jun 28 2018

Bibliographical note

Funding Information:
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 postprocessing, and our clinical research coordinators, Jacqueline Vachon and Joshua De Kam.

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

Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

Keywords

Freezing of gait (FOG)
Gait initiation
Parkinson’s disease
Supplementary motor area (SMA)
Transcranial direct current stimulation (tDCS)

PubMed: MeSH publication types

Journal Article

Publisher link

10.1007/s00415-018-8953-1

Cite this

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title = "The effects of anodal tDCS over the supplementary motor area on gait initiation in Parkinson{\textquoteright}s disease with freezing of gait: a pilot study",

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{\textquoteright}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.",

keywords = "Freezing of gait (FOG), Gait initiation, Parkinson{\textquoteright}s disease, Supplementary motor area (SMA), Transcranial direct current stimulation (tDCS)",

author = "Chiahao Lu and {Amundsen Huffmaster}, {Sommer L.} and Tuite, {Paul J.} and MacKinnon, {Colum D.}",

note = "Funding Information: 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 postprocessing, and our clinical research coordinators, Jacqueline Vachon and Joshua De Kam. Funding Information: 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. Preliminary findings from this study were presented in abstract form at the Society for Neuroscience Meeting in 2015 Publisher Copyright: {\textcopyright} 2018, Springer-Verlag GmbH Germany, part of Springer Nature.",

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T1 - The effects of anodal tDCS over the supplementary motor area on gait initiation in Parkinson’s disease with freezing of gait

T2 - a pilot study

AU - Lu, Chiahao

AU - Amundsen Huffmaster, Sommer L.

AU - Tuite, Paul J.

AU - MacKinnon, Colum D.

N1 - Funding Information: 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 postprocessing, and our clinical research coordinators, Jacqueline Vachon and Joshua De Kam. Funding Information: 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. Preliminary findings from this study were presented in abstract form at the Society for Neuroscience Meeting in 2015 Publisher Copyright: © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

PY - 2018/6/28

Y1 - 2018/6/28

N2 - 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.

AB - 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.

KW - Freezing of gait (FOG)

KW - Gait initiation

KW - Parkinson’s disease

KW - Supplementary motor area (SMA)

KW - Transcranial direct current stimulation (tDCS)

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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

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

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