Objective: To determine: 1. Is HD-tDCS safe and well-tolerated in PD? 2. Does combined HD-tDCS and physical exercise improve proprioception and balance in PD?

Background: Proprioception is decreased in people with Parkinson’s Disease (PD) and this reduction is clearly evident at early stages of the disease. Transcranial direct current stimulation (tDCS) combined with exercise can improve motor outcomes in people with PD. It is possible that high definition tDCS combined with exercise may increase proprioception in people with PD.

Methods: Randomized cross-over trial consisting of 8 participants with early to mid-stages PD, aged between 68 and 75 years (M=72.63 SD=2.62). Participants completed 4 weeks of experimental intervention (combining active HD-tDCS with exercises), and 4 weeks of control intervention (combining sham tDCS and cognitive training). Measurements were taken of ankle proprioception in inversion and plantarflexion, balance, symptom severity and fear of falling by a blinded physiotherapist at baseline, 2 weeks and 4 weeks.

Results: There was no significant change in proprioception during inversion or plantarflexion between experimental and control conditions. Participants had significantly, and clinically important, improved balance during the experimental condition compared with during the control condition (p = 0.006), with a mean difference of 3.25 out of 28 (95% CI 1.09 to 5.41). 100% of participants reported being unable to notice the difference between sham and active HD-tDCS protocols. No adverse events were reported.

Conclusions: Combined HD-tDCS and physical exercise did not significantly improve proprioception in PD sufferers, however balance was significantly improved. High definition transcranial direct current stimulation was well tolerated in this population.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/safety-and-efficacy-of-high-definition-tdcs-for-proprioception-and-balance-in-parkinsons-disease-a-pilot-randomised-trial/