Do you know brain stimulation improves gait function in Parkinson’s disease patients? Study finds

Parkinson’s disease (PD), which affects millions of people worldwide, causes gait irregularities that substantially decrease their quality of life. Despite the availability of several pharmacological, surgical, and rehabilitative treatments, their effectiveness is limited. This limitation has now been addressed by a group of Japanese researchers.
The researchers noticed significant gait improvements in individuals suffering from a range of neurological disorders, including Parkinson’s disease, by employing a novel neuromodulation technique that included gait-combined closed-loop transcranial electrical stimulation.
Parkinson’s disease (PD) is a severe neurological ailment characterised by a decline in motor function, particularly in gait irregularities. These gait issues, which are frequent in Parkinson’s disease patients, manifest themselves as shorter steps, reduced arm swing, sluggish motions, rigidity, and postural instability. While non-pharmacological techniques such as transcranial direct current stimulation have shown promise in enhancing motor performance, recent research has focused on gait-combined closed-loop stimulation, which synchronises brain stimulation with the individual’s walking rhythm.
A recent study that was released on June 9, 2023 in the Journal of Neurology, Neurosurgery & Psychiatry suggested a unique technique for improving gait, giving people with Parkinson’s disease (PD) new hope.
“We recently developed a novel neuromodulation approach using gait-combined closed-loop transcranial electrical stimulation (tES) and demonstrated promising gait improvements in patients who are post-stroke. Here, we tested the efficacy of this intervention in patients with Parkinsonian gait disturbances,” explained lead author Ippei Nojima from Shinshu University and Nagoya City University, Japan.
To this end, the clinical researchers from Japan recruited twenty-three patients with PD or Parkinson’s syndrome. All study participants were randomly assigned to receive either the active treatment or a “sham” treatment that mimics the active treatment but does not offer any therapeutic benefit.
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.
“Gait disturbance lowers activities of daily living in patients with PD and related disorders. However, the effectiveness of pharmacological, surgical, and rehabilitative treatments is limited. Our novel intervention might be able to improve physical function for not just patients with PD but also for those with other disabilities,” comments senior author Yoshino Ueki from the Department of Rehabilitation Medicine at Nagoya City University.
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.
Says Professor Nojima, “These 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.”
Interestingly, no patient dropped out during the study. Moreover, patients from both the groups (treatment and sham) showed good and comparable compliance. Side effects such as skin irritation, vertigo, or odd sensations/perceptions were also not observed in any of the volunteering patients. This study has special significance, considering the fact that Japan is witnessing a sharp rise in its elderly population.
“Patients with impacted gait have restricted daily activities. We successfully developed a new non-pharmacological and non-invasive intervention for the rehabilitation of patients with PD and other neurological disorders. Our breakthrough method could be used to restore gait in these patients,” concluded Professor Ueki. (ANI)