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. 2024 Apr 4;11(4):353.
doi: 10.3390/bioengineering11040353.

Direct Current Stimulation over the Primary Motor Cortex, Cerebellum, and Spinal Cord to Modulate Balance Performance: A Randomized Placebo-Controlled Trial

Jitka Veldema  1 , Teni Steingräber  1 , Leon von Grönheim  1 , Jana Wienecke  2 , Rieke Regel  1 , Thomas Schack  1 , Christoph Schütz  1
Affiliations

Direct Current Stimulation over the Primary Motor Cortex, Cerebellum, and Spinal Cord to Modulate Balance Performance: A Randomized Placebo-Controlled Trial

Jitka Veldema et al. Bioengineering (Basel). .

Abstract

Objectives: Existing applications of non-invasive brain stimulation in the modulation of balance ability are focused on the primary motor cortex (M1). It is conceivable that other brain and spinal cord areas may be comparable or more promising targets in this regard. This study compares transcranial direct current stimulation (tDCS) over (i) the M1, (ii) the cerebellum, and (iii) trans-spinal direct current stimulation (tsDCS) in the modulation of balance ability.

Methods: Forty-two sports students were randomized in this placebo-controlled study. Twenty minutes of anodal 1.5 mA t/tsDCS over (i) the M1, (ii) the cerebellum, and (iii) the spinal cord, as well as (iv) sham tDCS were applied to each subject. The Y Balance Test, Single Leg Landing Test, and Single Leg Squat Test were performed prior to and after each intervention.

Results: The Y Balance Test showed significant improvement after real stimulation of each region compared to sham stimulation. While tsDCS supported the balance ability of both legs, M1 and cerebellar tDCS supported right leg stand only. No significant differences were found in the Single Leg Landing Test and the Single Leg Squat Test.

Conclusions: Our data encourage the application of DCS over the cerebellum and spinal cord (in addition to the M1 region) in supporting balance control. Future research should investigate and compare the effects of different stimulation protocols (anodal or cathodal direct current stimulation (DCS), alternating current stimulation (ACS), high-definition DCS/ACS, closed-loop ACS) over these regions in healthy people and examine the potential of these approaches in the neurorehabilitation.

Keywords: balance; cerebellum; healthy people; postural control; primary motor cortex; spinal cord; tDCS; tsDCS.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
Electrodes positioning used for (a) M1 tDCS, (b) cerebellar tDCS, (c) spinal tDCS and (d) sham tDCS.
Figure 2
Figure 2
Intervention-induced changes (means and SD) in the Y Balance Test in relation to baseline.
Figure 3
Figure 3
Intervention-induced changes (means and SD) in Single Leg Squat Test and Single Leg Landing Test in relation to baseline. Notes: formula image = sham; formula image = M1; formula image = cerebellum; formula image = spinal.
See this image and copyright information in PMC

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