Brain Stimulation Helps Parkinson’s Patients

Gait-related disturbances adversely affect the quality of life of patients with Parkinson’s disease (PD), a condition affecting millions worldwide. 

Although various pharmacological, surgical, and rehabilitative treatments exist, their effectiveness is limited. Now, a team of researchers from Japan has successfully addressed this limitation. Using a novel neuromodulation approach that incorporates gait-combined closed-loop transcranial electrical stimulation, the team demonstrated significant gait improvements in patients with various neurological disorders including PD.

Parkinson’s disease (PD) is a debilitating neurodegenerative disease characterized by motor function decline, particularly in relation to gait disorders. These gait disorders manifest as decreased step length, reduced arm swing, slow movements, rigidity, and postural instability, which are prevalent among patients with PD. 

While non-pharmacological approaches like transcranial direct current stimulation show promise in improving motor function, recent research focuses on gait-combined closed-loop stimulation, which synchronizes brain stimulation with the individual’s gait rhythm. A recent study published on 9 June 2023 in the Journal of Neurology, Neurosurgery & Psychiatry proposes a novel intervention for gait improvement, thus creating new hope for patients with PD.

To this end, the clinical researchers from Japan recruited twenty-three patients with PD or Parkinson’s syndrome. 

During the course of the trial, an electrode carrying a low current (up to 2 mA) was externally affixed to the occipital region of the head. A reference electrode was then placed in the neck region to establish a stable electrical reference point and to complete the electrical circuit. The treatment included performing tES on the cerebellum in a non-invasive manner. The brain side showing severe impact was specifically targeted during the electrotherapy.

The cerebellum plays a key role in gate control. Therefore, the electrical stimulation of this region is likely to exert therapeutic benefits. The therapy showed encouraging results after just ten repetitions. 

The treatment group showed a significant improvement in gait parameters including speed, gait symmetry, and stride length.

Although the study has certain limitations, it suggests that the personalized brain stimulation, synchronized with individual gait rhythm, can effectively enhance gait function in PD and has the potential to be used as an adjunct therapy for gait rehabilitation.

Sources:

Ippei Nojima, Mitsuya Horiba, Kento Sahashi, Satoko Koganemaru, Satona Murakami, Kiminori Aoyama, Noriyuki Matsukawa, Yumie Ono, Tatsuya Mima, Yoshino Ueki. Gait-combined closed-loop brain stimulation can improve walking dynamics in Parkinsonian gait disturbances: a randomised-control trial. Journal of Neurology, Neurosurgery & Psychiatry, 2023; jnnp-2022-329966 DOI: 10.1136/jnnp-2022-329966

Shinshu University. (2023, August 8). Brain stimulation improves walking in patients with Parkinson’s disease: Novel non-pharmacological and non-invasive treatment may offer significant relief to and restore gait function in patients with neurological disorders. ScienceDaily. Retrieved August 8, 2023 from www.sciencedaily.com/releases/2023/08/230808110953.htm

Image from: 

https://unsplash.com/photos/QCF2ykBsC2I