Cerebellar Transcranial Direct Current Stimulation in Parkinson's Disease

Can Cerebellar Transcranial Direct Current Stimulation be Regarded as a Rational Therapeutic Option for Treating Parkinson's Disease ?

Background & Rationale:

Treatment options for Parkinson's Disease (PD) often face challenges due to the variety of clinical subtypes, differing individual responses, and disease progression. Given its portability, affordability, safety, and ease of use, cerebellar transcranial direct current stimulation (ctDCS) presents as a promising option for home-based treatment with medical telemonitoring in the near future.

Study Procedures:

Participants are invited to complete questionnaires regarding quality of life, anxiety and depression, and symptoms related to their PD.

On the first day, they will be assessed using the Movement Disorder Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III for motor impairment and the Cerebellar Cognitive Affective Syndrome scale (CCAS) for cognitive impairment. Participants will then undergo an additional 8 days of at-home cTDCS stimulation. On the 10th day, they will be reassessed using the MDS-UPDRS III and CCAS. One month later, they will complete again the questionnaires regarding quality of life, anxiety, depression, and symptoms related to their PD.

Objective:

Consequently, the primary goal is to investigate the effectiveness of ctDCS in addressing both motor and non-motor symptoms of PD

Inclusion Criteria:

• Patients with mild to moderate PD MDS-UPDRS part 1III or between 1 and 3 on Hoehn and Yahr score
• Patients > 18 years of agE
• Patients who have signed written informed consent

Exclusion Criteria:

• Pregnant women
• Patients ≤ 18 years of age
• Presence of intracranial metallic hardware (e.g., vascular clips, orthopedic material)
• Presence of an implanted electronic device (e.g., pacemaker, cochlear implants, deep brain stimulator)
• History of epileptic seizures
• Active or past neurological condition affecting upper limb control (e.g., stroke, degenerative disease, tumor, traumatic sequelae), or any neuromuscular (e.g., upper limb polyneuropathy, myopathy) or orthopedic condition impairing upper limb motor control
• Subject unable to understand or perform the required motor tasks
• Psychotropic polypharmacy (regular use of neuroleptics, anti-epileptics, benzodiazepines, etc.)