Transcranial Direct Current Stimulation (tDCS) and Parkinson's Disease
Condition: Parkinson's Disease
MeSH terms: Parkinson Disease
Study type: Interventional

Summary: 
      The use of low level electrical stimulation when applied over the head, also called
      transcranial direct current stimulation (tDCS), is being tested by several groups of
      researchers to see if tDCS can improve movements of persons with damage to the brain. The
      safety and potential benefits of tDCS to children or adults patients who are paralyzed
      because of brain damage are reported in the medical literature. In addition, some patients
      with Parkinson's disease (PD) experience improvement in memory and report better use of the
      hand after tDCS. The treatment requires putting electrodes (pads) over the head and sending
      very small amount of electrical current that the patient may feel as "little tingling".
      Application of tDCS takes 20 min. In this study we wish to test if tDCS application can
      improve stepping and walking ability of subjects with PD and if the improvement is the same
      as when walking on treadmill. We plan to test the subject's ability to step when pulled by a
      laboratory testing system and also test his/her walking ability. There will be 3 sessions 7
      days apart. In the first session the subject will be tested then treated for 20 min with tDCS
      and then tested again. In the second session the subject will be tested then walk on a
      treadmill for 20 min then tested again. In the third session the subject will be tested then
      walk on the treadmill for 20 min while receiving also tDCS and tested one last time at the
      end of the session. Each session will take between 2 and 3 hours.
    

Detailed description: 
      Recent advances in non-invasive electrical stimulation technology including transcranial
      direct current stimulation (tDCS) have provided novel and low risk options to rehabilitate
      the impaired ability of the central nervous system (CNS) to process sensorimotor information.
      Furthermore, tDCS appears to enhance CNS connectivity and there is preliminary evidence
      indicating that patients with Parkinson's Disease (PD) may experience improvement in working
      memory, the Unified Parkinson's Disease Rating Scale, simple reaction time and the Purdue
      Pegboard test. tDCS is inexpensive, portable and available for repeated home use. It may
      provide long-lasting enhancement of cortical activity in part because tDCS is easy to
      administer frequently and to combine it with other rehabilitation approaches including
      posture and gait training. However to date, no study has examined quantitatively the effects
      of tDCS on posture control and walking ability in patients with PD. As a first step we plan
      to identify the immediate effects of tDCS, as well as the added value of tDCS to treadmill
      exercise training, to improve posture and gait of individuals with PD.
    

Intervention name(s): Cranial Electric Stimulation (CES); Treadmill; CES and Treadmill
Intervention type(s): Device; Device; Device
Intervention description(s): We will follow the procedure described by several investigators as safe and effective. The participant will sit on a standard chair. Two commercially available surface electrodes will be embedded in an elastic head cup. Each electrode will be covered with a water soaked absorbent fabric. One positive (+) electrode will be placed over the primary motor cortex (M1) and pre-motor areas. One negative (-) electrode will be placed over the skin overlying the contra lateral supra-orbital region. The electrodes will be connected via 2 leads to a battery powered direct current stimulator. The stimulator will be programmed to deliver 0.975mA (peak 4mA) over 20 minutes.; The participant will walk on a treadmill for 20 minutes at the individually self-selected velocity determined at baseline.; Participants will have a combined session with CES while walking on the treadmill for 20 minutes at the individually self-selected velocity determined at baseline.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Parkinson's Disease; Cranial Electric Stimulation; Gait