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
Randomized Controlled Trial
. 2024 Sep 28;21(1):173.
doi: 10.1186/s12984-024-01457-z.

Cerebellar tDCS combined with augmented reality treadmill for freezing of gait in Parkinson's disease: a randomized controlled trial

Fabrizio Pisano  1 , Denise Mellace  2 , Ambra Fugatti  1 , Edoardo Nicolò Aiello  3 , Silvia Diotti  1 , Beatrice Curti  3 , Alessandra Giust  1 , Angelica Marfoli  2 , Cecilia Perin  4 , Angelica De Sandi  5 , Dario Alimonti  6 , Alberto Priori  7   8 , Roberta Ferrucci  9   10
Affiliations
Randomized Controlled Trial

Cerebellar tDCS combined with augmented reality treadmill for freezing of gait in Parkinson's disease: a randomized controlled trial

Fabrizio Pisano et al. J Neuroeng Rehabil. .

Abstract

Background: Parkinson's disease (PD) is often accompanied by gait disorders and freezing of gait (FoG), disabling symptoms that are resistant to conventional dopamine treatments. Given the cerebellum's connectivity with the motor cortex and basal ganglia, and its implication in PD, combining transcranial direct current stimulation targeting the cerebellum (ctDCS) with physical exercise might improve gait and balance.

Objective: This study aimed to evaluate the effectiveness of a novel rehabilitation approach that combines noninvasive cerebellar stimulation with motor-cognitive training via an augmented reality treadmill (C-Mill VR+) in individuals with PD and FoG.

Methods: Seventeen individuals with PD exhibiting FoG were enrolled in a randomized controlled trial. The participants were randomly assigned to a group receiving motor-cognitive training on the C-Mill VR+ with either ctDCS or sham ctDCS. Assessments were conducted pre-intervention (T0), post-intervention (T1) after 10 sessions, and at 4-week follow-up (T2), using various clinical scales. Additionally, C-Mill assessments of postural stability and gait were conducted at T0 and T1.

Results: Although no significant time*group interactions were observed for any of the clinical variables measured, some were found in the C-Mill measures. Specifically, right lower limb sway in static conditions, both with eyes open (OAD) and eyes closed (OCD), significantly improved at T1 in the ctDCS group compared with the sham group.

Conclusions: C-Mill outcomes indicate that the combined treatment may enhance motor control. Participants who received ctDCS along with augmented reality motor-cognitive training showed better postural stability.

Keywords: Augmented reality; Cerebellum; Freezing of gait; Physical exercise; Rehabilitation; Transcranial direct current stimulation.

PubMed Disclaimer

Conflict of interest statement

R.F. and A.P. are founders and shareholders of Newronika S.p.A. The other authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Flow diagram of participants in the study
Fig. 2
Fig. 2
Effects plot displaying the mean scores and standard error bars related to right lower limb sway in static conditions (A) with eyes open (OAD) and (B) with eyes closed (OCD) as detected by the C-Mill
Fig. 3
Fig. 3
Effects plot displaying the mean scores and standard error bars for left step length under obstacle avoidance conditions (LPSxO) as detected by the C-Mill
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Elbaz A, Carcaillon L, Kab S, Moisan F. Epidemiology of Parkinson’s disease. Rev Neurol (Paris). 2016;172:14–26. 10.1016/j.neurol.2015.09.012. - PubMed
    1. Mhyre TR, Boyd JT, Hamill RW, Maguire-Zeiss KA. Parkinson’s disease. Subcell Biochem. 2012;65:389–455. 10.1007/978-94-007-5416-4_16. - PMC - PubMed
    1. Rutz DG, Benninger DH. Physical therapy for Freezing of Gait and Gait impairments in Parkinson Disease: a systematic review. PM R. 2020;12:1140–56. 10.1002/pmrj.12337. - PubMed
    1. Cosentino C, Baccini M, Putzolu M, Ristori D, Avanzino L, Pelosin E. Effectiveness of Physiotherapy on Freezing of Gait in Parkinson’s Disease: A Systematic Review and Meta-Analyses. Mov Disord. 2020;35523–36. 10.1002/mds.27936. - PubMed
    1. Rahimpour S, Gaztanaga W, Yadav AP, Chang SJ, Krucoff MO, Cajigas I, Turner DA, Wang DD. Freezing of Gait in Parkinson’s Disease: invasive and noninvasive neuromodulation. Neuromodulation. 2021;24:829–42. 10.1111/ner.13347. - PMC - PubMed

Publication types