Category: Parkinson's Disease (Other)
Objective: To investigate the effects of sequential multi-target tDCS on gait performance in patients with PD using objective IMU-based gait analysis.
Background: Gait impairment and freezing of gait (FOG) are disabling features of Parkinson’s disease (PD) that are often resistant to pharmacologic treatment. Non-invasive brain stimulation, particularly transcranial direct current stimulation (tDCS), has shown potential benefits for gait dysfunction. Previous studies have targeted individual cortical regions such as the primary motor cortex (M1), supplementary motor area, or frontal cortex. However, whether sequential stimulation of multiple gait-related networks enhances therapeutic effects remains unknown.
Method: Fifty patients with PD were randomly assigned to three groups: (1) sequential multi-target stimulation (M1, frontal cortex, and cerebellum; 20 minutes each), (2) M1 stimulation alone (30 minutes), or (3) sham stimulation (30 minutes). Clinical assessments included UPDRS-III gait item, Freezing of Gait (FOG) questionnaire, and Timed Up and Go (TUG) test. Quantitative gait analysis was performed using a wearable IMU system (MotionCore), measuring basic gait parameters (gait speed, stride length, cadence) and advanced metrics including stride time variability, harmonic ratio, gait asymmetry, and turning velocity. Pre- and post-stimulation changes were compared between groups.
Results: The multi-target tDCS group demonstrated significant improvements in gait performance compared with the M1-only and sham groups. In multi-target group, gait speed increased from 0.92 ± 0.18 m/s to 1.08 ± 0.20 m/s (p<0.01), and stride length increased by 12%. Stride time variability decreased by 28%, and harmonic ratio improved significantly (p<0.05). TUG time improved from 12.4 ± 3.1 s to 9.8 ± 2.6 s, while FOG scores decreased by 32%. In contrast, the M1-only group showed modest improvements that did not differ significantly from the sham group.
Conclusion: Sequential stimulation of multiple gait-related brain regions may enhance the effects of tDCS on gait dysfunction in PD. Multi-target neuromodulation targeting motor, frontal, and cerebellar networks may represent a promising strategy for improving gait stability and reducing freezing in Parkinson’s disease.
To cite this abstract in AMA style:
DW. Lee, WY. Jang, KW. Park. Sequential Multi-Target tDCS Improves Gait in Parkinson’s Disease: A Randomized Controlled Study Using IMU-Based Gait Analysis [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/sequential-multi-target-tdcs-improves-gait-in-parkinsons-disease-a-randomized-controlled-study-using-imu-based-gait-analysis/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/sequential-multi-target-tdcs-improves-gait-in-parkinsons-disease-a-randomized-controlled-study-using-imu-based-gait-analysis/