P029 Effects of dual-mode non-invasive brain stimulation on freezing of gait in patients with Parkinson's disease. Issue 3 (March 2017)

• Record Type: Journal Article
• Authors: Chang, W.H.; Park, E.; Cho, J.-W.; Youn, J.-Y.; Kim, S.-W.; Kim, Y.K.; Lee, A.; Kim, Y.-H.
• Is Part Of: Clinical neurophysiology. Volume 128:Issue 3(2017:Mar.)
• Page Start: e23
• Publication Date: 2017-03
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2016.10.157
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Purpose: Our previous study demonstrated the favorable effect of repetitive transcranial magnetic stimulation (rTMS) over both the dominant primary motor cortex of lower leg (M1-LL) and the left dorsolateral prefrontal cortex (DLPFC). The aim of this study was to investigate the effects of dual-mode non-invasive brain stimulation (NBS) on FOG using both rTMS and tDCS in patients with PD. Methods: This study was a randomized controlled double-blind study comparing the effect of single vs. dual-mode stimulation. Thirty-two patients with PD that featured FOG were included and divided into two groups. For the dual-mode stimulation, 10 Hz rTMS over the dominant M1-LL and the anodal tDCS over the left DLPFC were simultaneously applied for 20 min per session, 5 sessions in a week. For the single stimulation, rTMS were applied at the same manner. Behavioral, neurophysiologic and cognitive outcomes were measured before, after, and 1 week after the intervention by the Timed Up and Go (TUG) test, Standing Start 180° Turn (SS-180° Turn Step/Time) test, Unified Parkinson's Disease Rating Scale (UPDRS) part III, FOG Questionnaire (FOG-Q), motor evoked potential, Korean version of Montreal Cognitive Assessment (K-MOCA), Digit span-Forward/Back and Trail Making-A/B. Results: There were significant improvements in TUG, SS-180° Turn Step, UPDRS part III and FOG-Q in both the dual-mode and the single stimulation group ( p < 0.05). The dual-mode stimulation also resulted in significant improvements in SS-180° Turn Time ( p = 0.008), K-MOCA ( p = 0.004), Digit span-Forward ( p = 0.015) and Trail making-B test ( p = 0.010), whereas single stimulation did not. Furthermore, improvement of Trail making-B test was significantly greater after the dual-mode stimulation than the single stimulation ( p = 0.024). Conclusion: The dual-mode stimulation using the 10 Hz rTMS over the dominant M1-LL and the anodal tDCS over the left DLPFC was more effective than single stimulation for improving FOG in combination with cognitive improvement in patients with PD.