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This study investigates the effects of Transcranial Direct Current Stimulation (tDCS) on postural control of children with Developmental Coordination Disorder (DCD). All participants will receive four conditions of stimulation, in a crossover protocol: cerebellar anodic, cerebellar cathodic, primary motor cortex anodic (M1) or sham tDCS.
Developmental Coordination Disorder (DCD) is a highly frequent neurodevelopmental disorder with negative impacts on children's motor repertoire, quality of life and general health. One of the main problems faced is the balance deficit, which although well characterized in this population, little is known about the etiological core of this impairment. The cerebellum appears to be a functionally impaired structure in DCD, but frontal motor areas are also involved. Transcranial Direct Current Stimulation (tDCS) is a noninvasive way of inducing local-specific polarity-dependent synaptic modulation. Cerebellar tDCS (CE-tDCS) is even more recent, with still unclear results on its effects on postural balance, with only one study in children, which requires us to better understand the type of stimulation necessary to induce balance improvement in children with DCD.
Thus, the investigators aimed to verify the effects of anodal tDCS over primary motor cortex (M1-atDCS) and CE-tDCS (anodic, cathodic and sham) on the balance of children with DCD, compared to children without DCD.
METHODS: Fifteen children with DCD (total MABC-2 and balance <15%, with DCDQ positive / TL positive) and 15 children without DCD (MABC-2 total and balance ≥50% and DCDQ negative) will be assessed by platform stabilometry (PS) before and after receiving M1, cerebellar anodic, cerebellar cathodic, primary motor cortex anodic (M1) or sham tDCS (crossover). They will be evaluated under conditions without proprioceptive manipulation (direct on PS) with open and closed eyes, and with proprioceptive manipulation (on foam surface) with open and closed eyes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Anodal tDCS (M1) | Active Comparator | tDCS applied over primary motor cortex. Dose: 1mA, 20 minutes |
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| Anodal Cerebellar tDCS | Experimental | tDCS applied over the cerebellum. Dose: 1mA, 20 minutes |
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| Cathodal Cerebellar tDCS | Experimental | tDCS applied over the cerebellum. Dose: 1mA, 20 minutes |
|
| Sham tDCS | Sham Comparator | tDCS applied over the cerebellum Dose: 1mA, 20 minutes (30s ON) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transcranial direct current stimulation (tDCS) | Device | Transcranial direct current stimulation is a noninvasive technique of neuronal modulation that has been used in different neurological conditions, including children with cerebral palsy. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from COP - AP axis | Postural instability will be evaluated using a force plate to record center of pressure displacement (COP) in antero-posterior (AP) axis in centimeters | Baseline and Post-tDCS (immediately after tDCS) |
| Change from COP - ML axis | Postural instability will be evaluated using a force plate to record center of pressure displacement (COP) in Mediolateral (ML) axis in centimeters | Baseline and Post-tDCS (immediately after tDCS) |
| Change from COP - area | Postural instability will be evaluated using a force plate to record center of pressure displacement (COP) area (cm²) | Baseline and Post-tDCS (immediately after tDCS) |
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| Measure | Description | Time Frame |
|---|---|---|
| Adverse effects | Adverse effects will be evaluated using structured questionnaire. Active collection uses a questionnaire with records of the duration (minutes or hours) and intensity (Numerical Rating Scale 0-10) of adverse symptoms reported by the patient. Complaints: Headache Scalp pain Tingling Itching Redness Burning sensations Sleepiness Trouble concentrating Nausea Mood change | Immediately after tDCS |
Inclusion Criteria:
Exclusion Criteria:
• Signs of excessive discomfort during or after any procedures or sessions involved in the research.
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| Name | Affiliation | Role |
|---|---|---|
| Renata H Hasue, pHD | University of Sao Paulo | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Physical Therapy, Communication Sciences and Disorders, and Occupational Therapy, Faculty of Medicine, University of São Paulo | São Paulo | 01246-903 | Brazil |
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| ID | Term |
|---|---|
| D019957 | Motor Skills Disorders |
| ID | Term |
|---|---|
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D065908 | Transcranial Direct Current Stimulation |
| ID | Term |
|---|---|
| D004599 | Electric Stimulation Therapy |
| D013812 | Therapeutics |
| D003295 | Convulsive Therapy |
| D013000 | Psychiatric Somatic Therapies |
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| D004191 | Behavioral Disciplines and Activities |
| D004597 | Electroshock |
| D011580 | Psychological Techniques |