Differential Effects of Cerebellar Transcranial Direct Current Stimulation with Gait Training on Functional Mobility, Balance, and Ataxia Symptoms.

Autor: Brito R; Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco Jornalista Aníbal Fernandes Avenue, Recife, Pernambuco, 50740-560, Brazil.; NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Recife, Brazil., Fabrício JV; Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco Jornalista Aníbal Fernandes Avenue, Recife, Pernambuco, 50740-560, Brazil., Araujo A; Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco Jornalista Aníbal Fernandes Avenue, Recife, Pernambuco, 50740-560, Brazil., Sacchi M; Universidade de São Paulo, São Paulo, Brazil., Baltar A; Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco Jornalista Aníbal Fernandes Avenue, Recife, Pernambuco, 50740-560, Brazil.; NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Recife, Brazil., Lima FA; Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco Jornalista Aníbal Fernandes Avenue, Recife, Pernambuco, 50740-560, Brazil., Ribeiro AC; Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco Jornalista Aníbal Fernandes Avenue, Recife, Pernambuco, 50740-560, Brazil., Sousa B; Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco Jornalista Aníbal Fernandes Avenue, Recife, Pernambuco, 50740-560, Brazil., Santos C; Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco Jornalista Aníbal Fernandes Avenue, Recife, Pernambuco, 50740-560, Brazil., Tanaka C; NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Recife, Brazil.; Universidade de São Paulo, São Paulo, Brazil., Monte-Silva K; Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco Jornalista Aníbal Fernandes Avenue, Recife, Pernambuco, 50740-560, Brazil. monte.silva@ufpe.br.; NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Recife, Brazil. monte.silva@ufpe.br.
Jazyk: angličtina
Zdroj: Cerebellum (London, England) [Cerebellum] 2024 Dec; Vol. 23 (6), pp. 2457-2467. Date of Electronic Publication: 2024 Oct 05.
DOI: 10.1007/s12311-024-01750-6
Abstrakt: Cerebellar transcranial direct current stimulation (ctDCS) has emerged as a promising, non-invasive, and safe neuromodulatory intervention capable of reducing ataxia symptoms and restoring cerebellum-motor connectivity. However, previous studies have only applied ctDCS in isolation, without association with specific training. This study aimed to assess the effect of ctDCS combined with gait training on functional mobility, balance, and symptoms and severity of ataxia. A randomized, triple-blind, sham-controlled, bi-center clinical trial was conducted with forty-four adults with cerebellar ataxia. Volunteers were randomized to receive five daily sessions of either real ctDCS (n = 11; 2 mA for 25 min) or sham ctDCS (n = 11) during gait training. Functional mobility, balance, and symptoms and severity of ataxia were assessed using the Time Up and Go test, the MiniBESTest, and the Scale for the Assessment and Rating of Ataxia (SARA), respectively, before and after the interventions. Both groups showed improvement in functional mobility, but there was no significant difference between the ctDCS and sham groups. However, the ctDCS group demonstrated significant improvements in cerebellar ataxia severity as reflected by SARA scores, particularly in tests of stance, sitting, speech disturbance, nose-finger test, and heel-shin slide test. Notably, no improvements were observed in balance. This study indicates that while ctDCS combined with gait training may improve specific symptoms of cerebellar ataxia, it does not significantly enhance overall functional mobility compared to sham treatment.
Competing Interests: Declarations. Ethical Approval: This study was approved by the local research ethics committee (No. ) and registered on clinicaltrials.org (NCT03703830 - https://clinicaltrials.gov/study/NCT03703830 ) in 2018-11-01. Competing Interests: The authors declare no competing interests.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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