Effect of Dual-mode and Dual-site Non-invasive Brain Stimulation on Freezing of Gait in Patients with Parkinson’s Disease

Publication date: Available online 11 February 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Won Hyuk Chang, Min Soo Kim, Eunhee Park, Jin Whan Cho, Jinyoung Youn, Yun Kwan Kim, Yun-Hee Kim
ObjectiveTo investigate the effect of dual-mode non-invasive brain stimulation (NIBS) with high-frequency repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex of the lower leg and anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex compared with rTMS alone in patients with Parkinson's disease (PD) with freezing of gait (FOG).DesignRandomized, double-blind, controlled study.SettingOutpatient rehabilitation clinics.ParticipantsThirty-two patients diagnosed as PD with FOG.InterventionsPatients in the dual-mode group underwent five consecutive daily sessions of dual-mode NIBS with high-frequency rTMS and tDCS simultaneously, whereas patients in the rTMS group underwent high-frequency rTMS and sham tDCS.Main Outcome MeasureAssessments of FOG, motor, ambulatory and cognitive function were performed three times: at baseline before NIBS, immediately after NIBS, and one week after cessation of NIBS.ResultsSerious adverse effects were not observed in either group. Significant changes over time were observed in FOG, motor and ambulatory function in each group, although there was no significant difference between the two groups. Executive function showed significant improvement after NIBS only in the dual-mode group.ConclusionsThese results suggest the potential for dual-mode NIBS to modulate two different cortices simultaneously. Dual-mode NIBS might be considered a novel therapeutic approach for patients with PD.



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