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Transcranial stimulation enhances beneficial effect of aerobic exercise on gait in Parkinson’s patients, study finds

Points 1 and 2 show the placement of the electrodes. The area covered by tDSC is shown in yellow. Image: Researcher’s archive. Credit: Rodrigo Vitório

Transcranial direct current stimulation (tDCS) can enhance the effectiveness of aerobic exercise and improve gait in Parkinson’s patients immediately after the session. Step time variability is reduced, reaction time is shortened, and gait execution control is strengthened.

These were the main findings of a 20-volunteer, randomized, double-blind, false-controlled crossover study by researchers at the Institute of Biological Sciences (IB-UNESP) at Sao Paulo State University in Rio Claro, Brazil.Articles reporting research are published at Nerve rehabilitation and nerve repair..

Participants participated in two 30-minute aerobic exercises (medium intensity cycling) at weekly intervals, in combination with a variety of active or “placebo” tDCS conditions.

Cognitive function and prefrontal cortex activity during gait were assessed before and after each session. Spatio-temporal parameters were also included in the analysis to assess gait variability, step length, and processing speed.

“Compared to pre-assessment, participants reduced step time variability, shortened simple selective reaction times, and stimulated hemispherical prefrontal cortex while walking only after aerobic exercise and active tDCS. We have increased our activity, “the article concludes. The author was supported by FAPESP.

According to Rodrigo Vitório, a professor at IB-UNESP and the last author of the article, aggressive intervention and placebo or quackery on separate days ensured a fair comparison. Half of the participants were given 20 minutes of actual tDCS, followed by 10 seconds of simulated tDCS. The other half performed the procedure in reverse order (fake followed by real treatment).

In tDCS, two small rectangular electrodes are attached to specific locations on the head. The appliance is portable and battery powered. The current is very weak (2mA), but enough to pass through the scalp and stimulate neurons in the area of ​​interest.

“Despite such restrictions Small sample sizeWe have found that transcranial stimulation activates the prefrontal cortex, a brain region that patients with Parkinson’s disease use more to control gait than healthy individuals. A single exercise-related session strengthened cognitive function and brought about other improvements, “said Vitório, a researcher at the Department of Health and Life Sciences at Northumbria University in the United Kingdom.

In an interview with Agência FAPESP, Vitório has already shown that one of the goals of this study is that aerobic exercise improves athletic activity, deeper than previous studies by the group in which he was a member of tDCS. I explained that it is to investigate the effect. In patients with Parkinson’s disease. “Transcranial stimulation is safe and is expected to increase the effectiveness of interventions and treatments. For example, it is often prescribed for depression,” he said.

According to the World Health Organization (WHO), about 1% of the world’s population over the age of 65 had Parkinson’s disease in 2019. In Brazil, the number of affected people is estimated to be 250,000 and notification is not required.

About Parkinson’s disease

Parkinson’s disease is a chronic, progressive, degenerative disease of the central nervous system, in which damage to nerve cells in the brain causes decreased levels of dopamine. Dopamine is a neurotransmitter that plays an important role in sending messages to the parts of the brain that control movement. And adjust.

When dopamine-producing neurons die, symptoms such as tremors, slowness, stiffness, and balance problems occur. Drugs are usually prescribed to preserve dopamine or replace the deficient dopamine in the brain, but because the disease is incurable, it can only control symptoms.

Patients with Parkinson’s disease have certain degenerations in the brain regions involved in the automatic control of movement, and attention resources are used to make up for this deficiency. In this study, tDSC-related aerobic exercise increased the compensatory capacity of volunteers.

The main symptoms of this disease are bradykinesia (bradykinesia), wrist, elbow, shoulder, thigh, ankle stiffness, and resting tremor of the hands, which can be unbalanced in severe cases. For example, improving walking can improve your quality of life and prevent falls.

Another research group at UNESP’s Baul campus recently found that the synergistic effect of stride while crossing obstacles was 53% lower in patients with Parkinson’s disease than in healthy individuals of the same age and weight.

The synergistic effect of step length refers to the ability of the locomotorium or musculoskeletal system to adapt movement by combining factors such as speed and foot position while attaching a curb to the sidewalk, for example.


Transcranial stimulation and / or physiotherapy improves walking speed in Parkinson’s disease


For more information:
Núbia Ribeiro Conceição et al, aerobic exercise combined with transcranial direct current stimulation in the prefrontal cortex of Parkinson’s disease: effects on cortical activity, gait, and cognition, Nerve rehabilitation and nerve repair (2021). DOI: 10.1177 / 15459683211019344

Quote: Transcranial stimulation enhances the beneficial effects of aerobic exercise on gait in patients with Parkinson’s disease, study results (2021, August 24) https://medicalxpress.com/news/2021-08-transcranial-beneficial Obtained from -effect-aerobic- on August 24, 2021 gait.html

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