Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 29;10(1):22.
doi: 10.1186/s40035-021-00245-2.

The effects of transcranial direct current stimulation on gait in patients with Parkinson's disease: a systematic review

Fateme Pol  1 , Mohammad Ali Salehinejad  2 , Hamzeh Baharlouei  3 , Michael A Nitsche  2   4
Affiliations

The effects of transcranial direct current stimulation on gait in patients with Parkinson's disease: a systematic review

Fateme Pol et al. Transl Neurodegener. .

Abstract

Background: Gait problems are an important symptom in Parkinson's disease (PD), a progressive neurodegenerative disease. Transcranial direct current stimulation (tDCS) is a neuromodulatory intervention that can modulate cortical excitability of the gait-related regions. Despite an increasing number of gait-related tDCS studies in PD, the efficacy of this technique for improving gait has not been systematically investigated yet. Here, we aimed to systematically explore the effects of tDCS on gait in PD, based on available experimental studies.

Methods: Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, PubMed, Web of Science, Scopus, and PEDro databases were searched for randomized clinical trials assessing the effect of tDCS on gait in patients with PD.

Results: Eighteen studies were included in this systematic review. Overall, tDCS targeting the motor cortex and supplementary motor area bilaterally seems to be promising for gait rehabilitation in PD. Studies of tDCS targeting the dorosolateral prefrontal cortex or cerebellum showed more heterogeneous results. More studies are needed to systematically compare the efficacy of different tDCS protocols, including protocols applying tDCS alone and/or in combination with conventional gait rehabilitation treatment in PD.

Conclusions: tDCS is a promising intervention approach to improving gait in PD. Anodal tDCS over the motor areas has shown a positive effect on gait, but stimulation of other areas is less promising. However, the heterogeneities of methods and results have made it difficult to draw firm conclusions. Therefore, systematic explorations of tDCS protocols are required to optimize the efficacy.

Keywords: Gait; Parkinson’s disease; Transcranial direct current stimulation.

PubMed Disclaimer

Conflict of interest statement

MAN is a member of the Scientific Advisory Boards of Neuroelectrics and Neurodevice. All other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The PRISMA flow chart of included studies investigating the effects of transcranial direct current stimulation on gait symptoms in Parkinson's Disease
See this image and copyright information in PMC

References

    1. Canning CG, Paul SS, Nieuwboer A. Prevention of falls in Parkinson's disease: a review of fall risk factors and the role of physical interventions. Neurodegener Dis Manag. 2014;4(3):203–21. - PubMed
    1. Jankovic J. Parkinson’s disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008;79(4):368–76. - PubMed
    1. Takakusaki K, Tomita N, Yano M. Substrates for normal gait and pathophysiology of gait disturbances with respect to the basal ganglia dysfunction. J Neurol. 2008;255(S4):19–29. doi: 10.1007/s00415-008-4004-7. - DOI - PubMed
    1. Takakusaki K. Functional neuroanatomy for posture and gait control. J Mov Disord. 2017;10(1):1–17. doi: 10.14802/jmd.16062. - DOI - PMC - PubMed
    1. Rizos A, Martinez-Martin P, Odin P, Antonini A, Kessel B, Kozul TK, Todorova A, Douiri A, Martin A, Stocchi F. Characterizing motor and non-motor aspects of early-morning off periods in Parkinson's disease: an international multicenter study. Parkinsonism Relat Disord. 2014;20(11):1231–1235. doi: 10.1016/j.parkreldis.2014.09.013. - DOI - PubMed

Publication types

MeSH terms