Authors (including presenting author) :
Cheng YF(1)
Affiliation :
(1)Physiotherapy Department, Princess Margaret Hospital
Introduction :
Patients with Parkinson's disease (PD) commonly experience gait impairment which adversely affects their quality of life. Abnormal cortical activations were observed during motor tasks and walking in patients with PD. Transcranial direct current stimulation (tDCS) has potential modulatory effects on cortical excitability which may be effective in promoting gait performance in patients with PD.
Objectives :
This systematic review and meta-analysis aim to investigate the effect of tDCS on improving gait performance in patients with PD and to identify the determinants of tDCS protocol which produced significant effects.
Methodology :
A literature search was conducted using the keywords “Parkinson’s disease”, “Parkinson”, “transcranial direct current stimulation” and “tDCS” in PubMed, CINAHL and CENTRAL. Random-effects model meta-analysis was performed to compare the effect sizes of gait-related outcomes. Subgroup analyses were used to investigate the effects of different stimulation targets, number of tDCS sessions and the presence of concurrent physical training.
Result & Outcome :
Eleven qualified randomized control trials were identified and analysed. The pooled results showed tDCS had no significant effect on overall gait performance. Subgroup analyses revealed a significant short-term improvement in gait speed in multi-target tDCS only (standardized mean difference=0.52, P=0.05).
The current review found the effects of tDCS on gait performance in patients with PD may depend on the location of stimulation. Multi-target tDCS on both motor and frontal cortex may be more effective in improving gait speed but further research is needed to fully understand the effects of multi-target tDCS in patients with PD.
