Safety and feasibility of transcranial direct current stimulation in amyotrophic lateral sclerosis – a pilot study with a single subject experimental design

• Published in: Physiotherapy theory and practice Vol. 35; no. 5; pp. 458 - 463
• Main Authors: Madhavan, Sangeetha, Sivaramakrishnan, Anjali, Bond, Sam, Jiang, Qin Li
• Format: Journal Article
• Language: English
• Published: England 04.05.2019
• Subjects: Adult; Amyotrophic Lateral Sclerosis - pathology; Amyotrophic Lateral Sclerosis - physiopathology; Amyotrophic Lateral Sclerosis - therapy; Gait; Gait Analysis; Humans; Male; Motor Activity; Motor Cortex - physiopathology; Motor Neurons - pathology; Muscle, Skeletal - innervation; Nerve Degeneration; Recovery of Function; Time Factors; Transcranial Direct Current Stimulation; Treatment Outcome; Walk Test; Amyotrophic lateral sclerosis; neurodegenerative disease; transcranial magnetic stimulation; transcranial direct current stimulation; cortical excitability
• ISSN: 0959-3985; 1532-5040; 1532-5040
• DOI: 10.1080/09593985.2018.1443536

Transcranial direct current stimulation (tDCS) has been explored as a neuromodulatory tool to prime motor function in several neurological disorders. Studies using tDCS in amyotrophic lateral sclerosis (ALS) are limited. We investigated the safety, feasibility and effects of long-term tDCS in an individual with ALS. A 36-year-old male diagnosed with clinically definite ALS received 12 sessions each of anodal, sham, and cathodal tDCS. Outcome measures included disease progression (revised ALS functional rating scale (ALSFRS-R)), clinical measures of endurance and mobility, and corticomotor excitability. No adverse events or change in disease progression were noticed during the study. Small improvement in gait speed (15% increase) was noticed with anodal tDCS only. This case study demonstrates the safety and feasibility of long-term facilitatory and inhibitory tDCS on a single participant with ALS. This study serves as a guideline for implementing tDCS in future ALS trials.