Andrea Baroni1, Giacomo Magro2, Carlotta Martinuzzi1, Laura Brondi1, Stefano Masiero3, Giada Milani1,4, Giulia Zani1, Antonella Bergonzoni1, Nino Basaglia1,5, Sofia Straudi1,5. 1. Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy. 2. Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padova, Italy. 3. Rehabilitation Unit, Department of Neuroscience, University of Padova, Padova, Italy. 4. Ferrara University, Doctoral Program in Translational Neurosciences and Neurotechnologies, Ferrara, Italy. 5. Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
Abstract
BACKGROUND: Balance and mobility impairments are frequent in people with multiple sclerosis, partly due to cerebellar dysfunctions. Task-oriented behavioural approaches were previously shown to promote physical function. The possibility exists that cerebellar transcranial direct current stimulation (ctDCS) applied during training, known to increase the excitability of the brain, can boost rehabilitation effects through modulation of cerebellum-brain inhibition. OBJECTIVE: To test the efficacy of cerebellar ctDCS stimulation combined with motor training on mobility and balance in people with multiple sclerosis. METHODS: 16 subjects were randomly assigned to receive real- or sham-ctDCS and task-oriented training daily over two weeks in a double-blind, randomised clinical pilot trial. Functional mobility, balance, walking performance and quality of life were tested before and after treatment and at two-week follow-up. Effects of cerebellar stimulation on psychological and executive functions were also recorded. RESULTS: Walking performance, balance and quality of life improved for both groups at post-treatment assessment which was maintained at 2-weeks follow up. A two-way ANOVA revealed a significant time effect for balance and walking performance. A significant interaction effect of time-treatment (F = 3.12, df = 2,26; p = 0.03) was found for motor aspects of quality of life assessment in patients who received real-ctDCS. CONCLUSIONS: Task-oriented training improves balance and mobility in people with multiple sclerosis, but ctDCS does not boost motor training effects.
BACKGROUND: Balance and mobility impairments are frequent in people with multiple sclerosis, partly due to cerebellar dysfunctions. Task-oriented behavioural approaches were previously shown to promote physical function. The possibility exists that cerebellar transcranial direct current stimulation (ctDCS) applied during training, known to increase the excitability of the brain, can boost rehabilitation effects through modulation of cerebellum-brain inhibition. OBJECTIVE: To test the efficacy of cerebellar ctDCS stimulation combined with motor training on mobility and balance in people with multiple sclerosis. METHODS: 16 subjects were randomly assigned to receive real- or sham-ctDCS and task-oriented training daily over two weeks in a double-blind, randomised clinical pilot trial. Functional mobility, balance, walking performance and quality of life were tested before and after treatment and at two-week follow-up. Effects of cerebellar stimulation on psychological and executive functions were also recorded. RESULTS: Walking performance, balance and quality of life improved for both groups at post-treatment assessment which was maintained at 2-weeks follow up. A two-way ANOVA revealed a significant time effect for balance and walking performance. A significant interaction effect of time-treatment (F = 3.12, df = 2,26; p = 0.03) was found for motor aspects of quality of life assessment in patients who received real-ctDCS. CONCLUSIONS: Task-oriented training improves balance and mobility in people with multiple sclerosis, but ctDCS does not boost motor training effects.