• Ippei Nojima, Mitsuya Horiba, Kento Sahashi, Satoko Koganemaru, Satona Murakami, Kiminori Aoyama, Noriyuki Matsukawa, Yumie Ono, Tatsuya Mima, and Yoshino Ueki.
• Physical Therapy, Shinshu University Graduate School of Health Sciences School of Health Sciences, Matsumoto, Nagano, Japan.
• J. Neurol. Neurosurg. Psychiatr. 2023 Nov 1; 94 (11): 938944938-944.

ObjectiveGait disturbance lowers activities of daily living in patients with Parkinson's disease (PD) and related disorders. However, the effectiveness of pharmacological, surgical and rehabilitative treatments is limited. We recently developed a novel neuromodulation approach using gait-combined closed-loop transcranial electrical stimulation (tES) for healthy volunteers and patients who are post-stroke, and achieved significant entrainment of gait rhythm and an increase in gait speed. Here, we tested the efficacy of this intervention in patients with Parkinsonian gait disturbances.MethodsTwenty-three patients were randomly assigned to a real intervention group using gait-combined closed-loop oscillatory tES over the cerebellum at the frequency of individualised comfortable gait rhythm, and to a sham control group.ResultsTen intervention sessions were completed for all patients and showed that the gait speed (F (1, 21)=13.0, p=0.002) and stride length (F (1, 21)=8.9, p=0.007) were significantly increased after tES, but not after sham stimulation. Moreover, gait symmetry measured by swing phase time (F (1, 21)=11.9, p=0.002) and subjective feelings about freezing (F (1, 21)=14.9, p=0.001) were significantly improved during gait.ConclusionsThese findings showed that gait-combined closed-loop tES over the cerebellum improved Parkinsonian gait disturbances, possibly through the modulation of brain networks generating gait rhythms. This new non-pharmacological and non-invasive intervention could be a breakthrough in restoring gait function in patients with PD and related disorders.© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

4 keywords...

hide…