Does tDCS Improve Motor Learning in Children With DCD?
Condition: Developmental Coordination Disorder
MeSH terms: Motor Skills Disorders
Study type: Interventional

Summary: 
      Transcrainial direct current stimulation (tDCS) has become increasingly popular over the past
      decade. tDCS is a safe and well-studied form of non-invasive brain stimulation. The purpose
      of the current study is to see if tDCS can improve motor function in children with
      developmental coordination disorder.

      Non-invasive brain stimulation is shown to positively affect motor performance in children
      with neurodevelopmental and/or neurological conditions. For example, tDCS improves hand motor
      function in children with paediatric stroke and cerebral palsy. The benefits of tDCS in
      developmental coordination disorder is unknown. The current study will assess children's
      motor performance before and after tDCS intervention.
    

Detailed description: 
      Developmental Coordination Disorder (DCD) is a chronic neurodevelopmental disorder
      characterized by impairments in coordinated motor abilities. Affected individuals show
      differences in brain maturation and early motor development, negatively impacting performance
      on everyday living tasks such as writing and participation in sports. Currently, there are
      few evidence-based therapeutic interventions for individuals diagnosed with DCD, and most are
      time consuming with modest effect sizes [1]. There is a pressing need to develop efficient,
      effective interventions to improve motor performance in children with DCD, as impairments
      often last into adulthood and can negatively impact long-term physical and mental health as
      well as social and academic abilities.

      The ability to enhance endogenous motor learning systems with non-invasive brain stimulation
      is now well established in adults [2, 3]. Research studies have demonstrated the same
      potential in the developing brain. For instance, tDCS can significantly enhance the
      acquisition of motor skills over a few brief training sessions in typically developing school
      aged children, with lasting effects [4]. Recent clinical trials in children with cerebral
      palsy and neonatal stroke also suggest therapeutic efficacy in children with motor impairment
      [5, 6, 7]. However, the use of tDCS in pediatric populations is limited [8]. As tDCS has been
      associated with improved motor outcomes in adults and children with motor impairment, it may
      be an effective intervention for children with DCD. This however has not been investigated.

      Research Questions & Objectives:

      The current study will investigate the therapeutic benefits of tDCS in adolescents with DCD.
      The primary aim is to determine changes in motor skill acquisition and learning during a
      skill-training paradigm that is paired with anodal tDCS or sham tDCS. We hypothesize that
      when compared to the sham tDCS group, the treatment tDCS group will show enhanced motor
      learning on tests of motor functioning.

      Secondarily we will also examine sensorimotor changes following tDCS intervention and
      pediatric brain stimulation safety/tolerability.

      Methods:

      A randomized, sham controlled clinical trial including a final sample of 30 school aged
      children diagnosed with DCD will be conducted. The current study will be using a
      well-supported stimulation protocol, utilized in children and adolescents in the absence of
      adverse side effects.
    

Intervention name(s): Transcrainial Direct Current Stimulation (tDCS)
Intervention type(s): Device
Intervention description(s): Transcranial direct current stimulation (tDCS) is a safe non-invasive form of brain stimulation, which modulates, through the application of weak direct current, cortical excitability. The applied subthreshold current passes through two externally placed electrodes, an anode and cathode.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The currently proposed study is a randomized, sham controlled clinical trial that includes 30 adolescents diagnosed with DCD. Participants will be randomized to one of two tDCS treatment groups.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Neurodevelopment; Pediatrics; Motor Learning; Brain Imaging; Neuroscience