TRANSCRANIAL DIRECT CURRENT STIMULATION (t-DCS) AS ADD-ON TO NEUROREHABILITATION OF PISA SYNDROME IN PARKINSON DISEASE
Parkinson Disease, Pisa Syndrome
About this trial
This is an interventional treatment trial for Parkinson Disease focused on measuring Parkinson Disease, Pisa Syndrome, Transcranial direct current stimulation
Eligibility Criteria
Inclusion Criteria:
- age between 18 and 80 years;
- Hoehn and Yahr stage between II and III;
- Mini-Mental State Examination score above 24;
- lateral trunk flexion of at least 10° at baseline.
Exclusion Criteria:
- history of major psychiatric or other neurological conditions;
- history of back surgery, tumors or infections of the spine, intradural or extradural hematoma, ankylosing spondylitis, spinal stenosis;
- history of idiopathic scoliosis;
- botulin toxin treatment in the previous year;
- any change in dose or regimen of the anti-parkinsonian therapy in the last month before enrolment.
Thirty patients affected by Parkinson' Disease (PD) and Pisa Syndrome (PS) were consecutive enrolled among those attending the Neurorehabilitation Department of the IRCCS Mondino Foundation (Pavia, Italy). Idiopathic PD was diagnosed according to the Movement Disorders Society clinical diagnostic criteria for PD. Pisa syndrome was clinically diagnosed according to the following criteria:
- a lateral flexion of the trunk with a homogenous angle between sacrum and spinous process of the 7th cervical vertebra;
- an ipsilateral axial rotation of the trunk around the sagittal axis, that leads to a higher and anterior position of the shoulder contralateral to the side of trunk deviation;
- the worsening of the postural disorder during standing position, sitting position and gait;
- the improvement of the postural disorder in supine position.
Sites / Locations
- Neurorehabilitation Department
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
tDCS group
Sham Group
Patients randomized to the experimental group were treated with the following parameters: duration of stimulation of 20 minutes per session with a 2 mA intensity delivered at anodal and cathodal levels.
The stimulation setting was exactly the same of the experimental group but the stimulation intensity was set according to a ramping up/ramping down method and delivered only in the first and last 30 seconds of each session. This stimulation paradigm is insufficient to produce a meaningful therapeutic effect, but it is necessary to guarantee the blind condition as it mimics the possible initial tingling sensation associated with active stimulation.