Transcranial Direct Current Stimulation (tDCS) and Parkinson's Disease
28 de octubre de 2019 actualizado por: Gad Alon, University of Maryland, Baltimore
Can Transcranial Direct Current Stimulation (tDCS)Modulate Protective Stepping and Gait Performance of People With Parkinson's Disease
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.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Descripción detallada
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.
Tipo de estudio
Intervencionista
Inscripción (Actual)
10
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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Maryland
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Baltimore, Maryland, Estados Unidos, 21201
- PTRS Research Lab
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años a 85 años (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Diagnosis of adult onset of PD
- A history of freezing of gait (FOG) as evidence by clinical assessment
- A stable regimen of anti-parkinsonian medications
- Ability to walk at least 10m without assistance
- Ability to walk on a treadmill for 20 minutes
- Personal weight of less than 500 Lb (because the suspension harness over the treadmill is limited to 500 Lb
- Stage 3 of the Hoehn and Yahr disability scale
- A score of >24 on the Mini Mental State Examination
Exclusion Criteria:
- Evidence of any clinically significant functional impairment related to cardiovascular, pulmonary, metabolic, other neurologic or musculoskeletal disease criterial that would preclude participation in training
- Any medical condition that might require other medical or surgical treatment during the study period
- A history of brain surgery or placement of a deep brain stimulator
- Dyskinesias > grade 2 on the Unified Parkinson's Disease Rating Scale (UPDRS)
- Any uncorrected vision or hearing problems that may limit daily activities or communication
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: N / A
- Modelo Intervencionista: Asignación de un solo grupo
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: Single Group
10 subjects with Parkinson's Disease receiving tPCS during the first session, treadmill walk, 7-10 days later (second session, and combined tPCS and treadmill 7-10 days week later (third session)
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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.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Stride Length
Periodo de tiempo: Data collection occurred before and immediately after each training session
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Stride Length was measured in centimeters
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Data collection occurred before and immediately after each training session
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Gait Velocity
Periodo de tiempo: Data collection occurred before and immediately after each training session
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Gait Velocity was measured in meters per second
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Data collection occurred before and immediately after each training session
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Cadence
Periodo de tiempo: Data collection occurred before and immediately after each training session
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Cadence was measured in steps per minute
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Data collection occurred before and immediately after each training session
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Number of Steps to Regain Balance
Periodo de tiempo: Data collection occurred before and immediately after each training session
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Steps to regain balance were measured by the number of steps needed to recover standing balance.
The steps were counted using a custom software of the motion capture system.
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Data collection occurred before and immediately after each training session
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First Step Length
Periodo de tiempo: Data collection occurred before and immediately after each training session
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First step length was measured in meters from the starting position of the foot to the maximum displacement of the foot after the first step.
Measurements were taken separately for forward and backward first step.
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Data collection occurred before and immediately after each training session
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First Step Velocity
Periodo de tiempo: Data collection occurred before and immediately after each training session
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First step velocity was measured in meters per second
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Data collection occurred before and immediately after each training session
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Investigadores
- Investigador principal: Gad Alon, PhD, PT, University of Maryland, Baltimore
- Investigador principal: Mark W Rogers, PhD, PT, University of Maryland, Baltimore
- Investigador principal: Lisa Shulman, MD, Univeristy of Maryland, Baltimore
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de enero de 2010
Finalización primaria (Actual)
1 de junio de 2011
Finalización del estudio (Actual)
1 de junio de 2011
Fechas de registro del estudio
Enviado por primera vez
19 de marzo de 2010
Primero enviado que cumplió con los criterios de control de calidad
8 de abril de 2010
Publicado por primera vez (Estimar)
9 de abril de 2010
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
30 de octubre de 2019
Última actualización enviada que cumplió con los criterios de control de calidad
28 de octubre de 2019
Última verificación
1 de octubre de 2019
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- HP-00040670
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