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Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease
Author(s) -
Fregni Felipe,
Boggio Paulo S.,
Santos Marcelo C.,
Lima Moises,
Vieira Adriana L.,
Rigonatti Sergio P.,
Silva M. Teresa A.,
Barbosa Egberto R.,
Nitsche Michael A.,
PascualLeone Alvaro
Publication year - 2006
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21012
Subject(s) - transcranial direct current stimulation , stimulation , motor cortex , transcranial magnetic stimulation , brain stimulation , parkinson's disease , neuroscience , deep brain stimulation , primary motor cortex , subthalamic nucleus , psychology , neuromodulation , medicine , transcranial alternating current stimulation , disease
Abstract Electrical stimulation of deep brain structures, such as globus pallidus and subthalamic nucleus, is widely accepted as a therapeutic tool for patients with Parkinson's disease (PD). Cortical stimulation either with epidural implanted electrodes or repetitive transcranial magnetic stimulation can be associated with motor function enhancement in PD. We aimed to study the effects of another noninvasive technique of cortical brain stimulation, transcranial direct current stimulation (tDCS), on motor function and motor‐evoked potential (MEP) characteristics of PD patients. We tested tDCS using different electrode montages [anodal stimulation of primary motor cortex (M1), cathodal stimulation of M1, anodal stimulation of dorsolateral prefrontal cortex (DLPFC), and sham‐stimulation] and evaluated the effects on motor function—as indexed by Unified Parkinson's Disease Rating Scale (UPDRS), simple reaction time (sRT) and Purdue Pegboard test—and on corticospinal motor excitability (MEP characteristics). All experiments were performed in a double‐blinded manner. Anodal stimulation of M1 was associated with a significant improvement of motor function compared to sham‐stimulation in the UPDRS ( P < 0.001) and sRT ( P = 0.019). This effect was not observed for cathodal stimulation of M1 or anodal stimulation of DLPFC. Furthermore, whereas anodal stimulation of M1 significantly increased MEP amplitude and area, cathodal stimulation of M1 significantly decreased them. There was a trend toward a significant correlation between motor function improvement after M1 anodal–tDCS and MEP area increase. These results confirm and extend the notion that cortical brain stimulation might improve motor function in patients with PD. © 2006 Movement Disorder Society