Nofar Schneider1,2, Moria Dagan1,2, Racheli Katz3, Pablo Cornejo Thumm1, Marina Brozgol1, Nir Giladi1,2,4, Brad Manor5,6,7, Anat Mirelman1,2,4, Jeffery M Hausdorff8,9,10,11. 1. Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel. 2. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. 3. Department of Physical Therapy, Sacker School of Medicine, Tel Aviv, Israel. 4. Department of Neurology, Sacker School of Medicine, Tel Aviv, Israel. 5. Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA. 6. Harvard Medical School, Boston, MA, USA. 7. Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. 8. Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel. jhausdor@tlvmc.gov.il. 9. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. jhausdor@tlvmc.gov.il. 10. Department of Physical Therapy, Sacker School of Medicine, Tel Aviv, Israel. jhausdor@tlvmc.gov.il. 11. Department of Orthopaedic Surgery, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA. jhausdor@tlvmc.gov.il.
Abstract
BACKGROUND: The performance of a secondary task while walking increases motor-cognitive interference and exacerbates fall risk in older adults. Previous studies have demonstrated that transcranial direct current stimulation (tDCS) may improve certain types of dual-task performance, and, that tDCS delivered during the performance of a task may augment the benefits of stimulation, potentially reducing motor-cognitive interference. However, it is not yet known if combining multi-target tDCS with the simultaneous performance of a task related to the tDCS targets reduces or increases dual-task walking costs among older adults. The objectives of the present work were (1) To examine whether tDCS applied during the performance of a task that putatively utilizes the brain networks targeted by the neuro-stimulation reduces dual-task costs, and (2) to compare the immediate after-effects of tDCS applied during walking, during seated-rest, and during sham stimulation while walking, on dual-task walking costs in older adults. We also explored the impact on postural sway and other measures of cognitive function. METHODS: A double-blind, 'within-subject' cross-over pilot study evaluated the effects of 20 min of anodal tDCS targeting both the primary motor cortex (M1) and the left dorsolateral prefrontal cortex (lDLPFC) in 25 healthy older adults (73.9 ± 5.2 years). Three stimulation conditions were assessed in three separate sessions: (1) tDCS while walking in a complex environment (tDCS + walking), (2) tDCSwhile seated (tDCS + seated), and (3) walking in a complex environment with shamtDCS (sham + walking). The complex walking condition utilized virtual reality to tax motor and cognitive abilities. During each session, usual-walking, dual-task walking, quiet standing sway, and cognitive function (e.g., Stroop test) were assessed before and immediately after stimulation. Dual-task costs to gait speed and other measures were computed. RESULTS: The dual-task cost to gait speed was reduced after tDCS + walking (p = 0.004) as compared to baseline values. Neither tDCS + seated (p = 0.173) nor sham + walking (p = 0.826) influenced this outcome. Similar results were seen for other gait measures and for Stroop performance. Sway was not affected by tDCS. CONCLUSIONS:tDCS delivered during the performance of challenging walking decreased the dual-task cost to walking in older adults when they were tested just after stimulation. These results support the existence of a state-dependent impact of neuro-modulation that may set the stage for a more optimal neuro-rehabilitation. TRIAL REGISTRATION: Clinical Trials Gov Registrations Number: NCT02954328.
RCT Entities:
BACKGROUND: The performance of a secondary task while walking increases motor-cognitive interference and exacerbates fall risk in older adults. Previous studies have demonstrated that transcranial direct current stimulation (tDCS) may improve certain types of dual-task performance, and, that tDCS delivered during the performance of a task may augment the benefits of stimulation, potentially reducing motor-cognitive interference. However, it is not yet known if combining multi-target tDCS with the simultaneous performance of a task related to the tDCS targets reduces or increases dual-task walking costs among older adults. The objectives of the present work were (1) To examine whether tDCS applied during the performance of a task that putatively utilizes the brain networks targeted by the neuro-stimulation reduces dual-task costs, and (2) to compare the immediate after-effects of tDCS applied during walking, during seated-rest, and during sham stimulation while walking, on dual-task walking costs in older adults. We also explored the impact on postural sway and other measures of cognitive function. METHODS: A double-blind, 'within-subject' cross-over pilot study evaluated the effects of 20 min of anodal tDCS targeting both the primary motor cortex (M1) and the left dorsolateral prefrontal cortex (lDLPFC) in 25 healthy older adults (73.9 ± 5.2 years). Three stimulation conditions were assessed in three separate sessions: (1) tDCS while walking in a complex environment (tDCS + walking), (2) tDCS while seated (tDCS + seated), and (3) walking in a complex environment with sham tDCS (sham + walking). The complex walking condition utilized virtual reality to tax motor and cognitive abilities. During each session, usual-walking, dual-task walking, quiet standing sway, and cognitive function (e.g., Stroop test) were assessed before and immediately after stimulation. Dual-task costs to gait speed and other measures were computed. RESULTS: The dual-task cost to gait speed was reduced after tDCS + walking (p = 0.004) as compared to baseline values. Neither tDCS + seated (p = 0.173) nor sham + walking (p = 0.826) influenced this outcome. Similar results were seen for other gait measures and for Stroop performance. Sway was not affected by tDCS. CONCLUSIONS: tDCS delivered during the performance of challenging walking decreased the dual-task cost to walking in older adults when they were tested just after stimulation. These results support the existence of a state-dependent impact of neuro-modulation that may set the stage for a more optimal neuro-rehabilitation. TRIAL REGISTRATION: Clinical Trials Gov Registrations Number: NCT02954328.
Authors: Maria Clara D Soares de Moura; Fuad A Hazime; Luana V Marotti Aparicio; Luanda A C Grecco; André R Brunoni; Renata Hydeé Hasue Journal: Somatosens Mot Res Date: 2019-06-11 Impact factor: 1.111
Authors: Jean-Pascal Lefaucheur; Andrea Antal; Samar S Ayache; David H Benninger; Jérôme Brunelin; Filippo Cogiamanian; Maria Cotelli; Dirk De Ridder; Roberta Ferrucci; Berthold Langguth; Paola Marangolo; Veit Mylius; Michael A Nitsche; Frank Padberg; Ulrich Palm; Emmanuel Poulet; Alberto Priori; Simone Rossi; Martin Schecklmann; Sven Vanneste; Ulf Ziemann; Luis Garcia-Larrea; Walter Paulus Journal: Clin Neurophysiol Date: 2016-10-29 Impact factor: 3.708
Authors: Sudeshna A Chatterjee; Rachael D Seidler; Jared W Skinner; Paige E Lysne; Chanoan Sumonthee; Samuel S Wu; Ronald A Cohen; Dorian K Rose; Adam J Woods; David J Clark Journal: Neuromodulation Date: 2022-04-08