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Transcranial direct current stimulation plus concurrent activity may influence task prioritization during walking in people with Parkinson’s disease – initial findings

Authors Criminger C, Swank C, Almutairi S, Mehta J

Received 6 January 2018

Accepted for publication 22 March 2018

Published 25 May 2018 Volume 2018:8 Pages 25—32


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Peter Hedera

Christina Criminger,1 Chad Swank,2 Sattam Almutairi,2 Jyutika Mehta3

1Department of Physical Therapy, Winston-Salem State University, Winston-Salem, NC, USA; 2School of Physical Therapy, Texas Woman’s University, Dallas, TX, USA; 3Department of Communication Science and Disorders, Texas Woman’s University, Dallas, TX, USA

Introduction: Walking for people with Parkinson’s disease (PD) degrades during motor–cognitive interplay (ie, dual-task conditions). Current management of PD improves motor symptoms but inadequately addresses cognitive function, indicating a necessity for novel interventions. In this pilot study, we examined bi-hemisphere transcranial direct current stimulation (tDCS) with concurrent activity and dual-task walking in people with PD.
Methods: Participants received 3 sessions (tDCSsitting, tDCSbike, tDCSWii) of bilateral tDCS (dorsolateral prefrontal cortex; left = anode, right = cathode) at 2 mA and 1 sham session (tDCSsham). Sessions were randomized, single-blinded, and performed during medication “ON” times separated by 7±2 days. Following each session, participants performed Timed Up and Go (TUG) single, dual-task conditions (TUGalone, TUGmotor, TUGcognitive).
Results: Sixteen participants with PD completed this study (mean age=68.13±9.76 years, ­Unified Parkinson’s Disease Rating Scale mean=40.31±18.27, Repeatable Battery for the Assessment of Neuropsychological Status mean=84.13 [13th percentile]). No differences were observed for TUG conditions between tDCS sessions. Dual task cost for TUGmotor, 14.73% (tDCSSitting), 17.78% (tDCSBike), 15.97% (tDCSWii)), 19.02% (tDCSSham); for TUGcognitive (walking), 20.01% (tDCSSitting), 18.7% (tDCSBike), 31.18% (tDCSWii), 20.01% (tDCSSham); for TUGcognitive (cognitive), 33.72% (tDCSSitting), 14.99% (tDCSBike), 4.42% (tDCSWii), 19.11% (tDCSsham).
Conclusion: Our bi-hemisphere tDCS paired with concurrent activities did not lessen dual-task cost in participants with PD but appeared to influence task prioritization. Further investigation with a larger sample size is warranted.

Keywords: dual task interference, gait, executive function, non-invasive brain stimulation, novel task, motor-cognitive interplay

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