Safety and immediate effect of noninvasive transcranial pulsed current stimulation on gait and balance in Parkinson disease.

ABSTRACT

BACKGROUND: Noninvasive electrical stimulation of the brain (ESB) is being investigated as a valued intervention to enhance motor performance. OBJECTIVE: To ascertain the safety and ability of transcranial pulsed current stimulation (tPCS) to modulate variables of protective stepping and gait of individuals with Parkinson's disease. METHOD: Ten patients participated in a pilot study. During the first session, a tPCS delivered current for 20 minutes via a positive electrode placed over the primary motor area (M1). In week 2, participants walked for 20 minutes on a treadmill. In week 3, tPCS and treadmill for 20 minutes were combined. Pre-testing and post-testing of gait and protective stepping were administered, comparing post-intervention (tPCS alone, treadmill alone, tPCS + treadmill) with pre-intervention data. The 3 interventions were compared by calculating the difference between post-intervention and pre-intervention data. A significance level of P < .05 was adopted. RESULTS: Stride length increased from 102.1 ± 24.4 to 111.2 ± 22.1 cm, and gait velocity increased from 0.90 ± 0.23 to 0.985 ± 0.19 m/s after tPCS. Treadmill or treadmill + tPCS did not result in changes in the studied gait parameters. The tPCS session increased gait velocity and stride length significantly compared with treadmill or tPCS + treadmill. Overall, the number of steps needed to recover balance decreased after tPCS and tPCS + treadmill. CONCLUSION: Noninvasive tPCS over the primary motor cortex had no adverse effects on those with long-standing Parkinson's disease and may lead to acute improvement of gait and balance recovery.