Long term clinical and neurophysiological effects of cerebellar transcranial direct current stimulation in patients with neurodegenerative ataxia

Brain Stimul. Mar-Apr 2017;10(2):242-250. doi: 10.1016/j.brs.2016.11.001. Epub 2016 Nov 3.

Abstract

Background: Neurodegenerative cerebellar ataxias represent a group of disabling disorders for which we currently lack effective therapies. Cerebellar transcranial direct current stimulation (tDCS) is a non-invasive technique, which has been demonstrated to modulate cerebellar excitability and improve symptoms in patients with cerebellar ataxias.

Objective: The present study investigated whether a two-weeks' treatment with cerebellar anodal tDCS could improve symptoms in patients with neurodegenerative cerebellar ataxia and could modulate cerebello-motor connectivity, at short and long term.

Methods: We performed a double-blind, randomized, sham controlled trial with cerebellar tDCS (5 days/week for 2 weeks) in twenty patients with ataxia. Each patient underwent a clinical evaluation pre- and post-anodal tDCS or sham stimulation. A follow-up evaluation was performed at one and three months. Cerebello-motor connectivity was evaluated using transcranial magnetic stimulation (TMS) at baseline and at follow-up.

Results: Patients who underwent anodal tDCS showed a significant improvement in all performance scores (scale for the assessment and rating of ataxia, international cooperative ataxia rating scale, 9-hole peg test, 8-m walking time) and in cerebellar brain inhibition compared to patients who underwent sham stimulation.

Conclusions: A two-weeks' treatment with anodal cerebellar tDCS improves symptoms in patients with ataxia and restores physiological cerebellar brain inhibition pathways. Cerebellar tDCS might represent a promising future therapeutic and rehabilitative approach in patients with neurodegenerative ataxia.

Keywords: Cerebellar ataxia; Cerebellar stimulation; Transcranial direct current stimulation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Ataxia / physiopathology*
  • Ataxia / therapy*
  • Cerebellum / physiology*
  • Double-Blind Method
  • Electrodes
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Cortex / physiology
  • Neurodegenerative Diseases / physiopathology*
  • Neurodegenerative Diseases / therapy*
  • Time Factors
  • Transcranial Direct Current Stimulation / methods*
  • Transcranial Magnetic Stimulation / methods
  • Treatment Outcome
  • Walking / physiology