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

• Published in: Brain stimulation Vol. 10; no. 2; pp. 242 - 250
• Main Authors: Benussi, A, Dell’Era, V, Cotelli, M.S, Turla, M, Casali, C, Padovani, A, Borroni, B
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2017
• Subjects: Adult; Aged; Ataxia - physiopathology; Ataxia - therapy; Cerebellar ataxia; Cerebellar stimulation; Cerebellum - physiology; Double-Blind Method; Electrodes; Female; Humans; Male; Middle Aged; Motor Cortex - physiology; Neurodegenerative Diseases - physiopathology; Neurodegenerative Diseases - therapy; Neurology; Time Factors; Transcranial direct current stimulation; Transcranial Direct Current Stimulation - methods; Transcranial Magnetic Stimulation - methods; Treatment Outcome; Walking - physiology; Transcranial direct current stimulation; Cerebellar ataxia; Cerebellar stimulation
• ISSN: 1935-861X; 1876-4754
• DOI: 10.1016/j.brs.2016.11.001

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.