Objective: To evaluate the clinical effects of anodal Transcranial Direct Current Stimulation (tDCS) application on sensorimotor cortex in a group of early-onset Parkinson’s Disease patients.

Background: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique used for therapeutic modulation of cortical excitability in various neurological diseases [1], including Parkinson’s Disease (PD) [2]. Early-onset PD (EOPD) is a PD subtype which affects young patients with severe impact on quality of life. To date, tDCS has never been specifically applied to EOPD patients.

Method: We recruited 11 idiopathic EOPD patients. tDCS was administered by a transcranial direct current stimulator (Model BrainSTIM, EMS) with the anode placed over the left sensorimotor cortical area (C3) and the cathode over the contralateral supraorbital ridge (Fp2). The protocol consisted of 10 sessions of stimulation of 20 minutes each, administered in two weeks, with a current intensity of 2mA. Participants were assessed at baseline and at the end of the stimulation cycle with Unified Parkinson’s Disease Ranking Scale (UPDRS) part III, Non-motor symptoms scale (NMSS), PD-cognitive rating scale (PD-CRS), and PD Quality of Life Questionnaire-39 (PDQ-39). Paired T-test was used to compare changes in clinical scores.

Results: At the end of the protocol significant score reduction was highlighted in NMSS (M 32,36± DS 29,07 vs 17,45±20,92, p=0.001) and in PD-CRS (M 100,82±13,95 vs 106,55±13,97, p=0. 040). Total UPDRSIII score did not change pre and post treatment. Grouping the items of the scale into rigidity, bradykinesia and tremor subscores, we found that the rigidity subscore was significantly reduced (M 0,67±0,78 vs 0,42±0,70, p=0.05). PDQ-39 score was unmodified. No relevant side effects were recorded.

Conclusion: This pilot study showed that a 10 session-long protocol of anodal sensorimotor tDCS might exert beneficial clinical effects in EOPD patients in non-motor symptoms and cognitive performances. Motor symptoms did not significantly improve, albeit some amelioration was noticed in rigidity. Further confirmation in larger samples and with sham-controlled subjects is now needed. However, tDCS emerges as a safe, well-tolerated, promising therapeutic option for EOPD.

References: 1) Woods AJ, Antal A, Bikson M, et al. A technical guide to tDCS, and related non-invasive brain stimulation tools. Clin Neurophysiol. 2016;127(2):1031-1048. doi:10.1016/j.clinph.2015.11.012

2) Liu X, Liu H, Liu Z, et al. Transcranial Direct Current Stimulation for Parkinson’s Disease: A Systematic Review and Meta-Analysis. Front Aging Neurosci. 2021;13:746797. Published 2021 Oct 28. doi:10.3389/fnagi.2021.746797

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MDS Abstracts - https://www.mdsabstracts.org/abstract/anodal-transcranial-direct-current-stimulation-tdcs-on-sensorimotor-cortex-in-patients-with-early-onset-parkinsons-disease-a-pilot-study/