Cerebellar Ataxia Symptoms Improved Short and Long Term by Cerebellar Transcranial Direct Current Stimulation: Presented at MDS

By Chris Berrie

BERLIN -- June 24, 2016 -- Anodal cerebellar transcranial direct current stimulation (tDCS) significantly improves symptoms over both the short and long term in patients with cerebellar ataxia, according to a study presented here at the 20th International Congress of Parkinson's Disease and Movement Disorders (MDS).

Valentina Dell’Era, MD, Centre for Aging Brain and Neurodegenerative disorders, Neurological Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy, presented the study on June 22.

Cerebellar ataxias are a group of disabling disorders that currently lack effective therapies. However, as Dr. Dell’Era explained initially, “In the literature, cerebellar tDCS has been demonstrated to improve symptoms in patients with cerebellar ataxia, but no studies have demonstrated long-term effects of this technique.”

Thus, the researchers investigated this noninvasive technique to determine whether sessions of cerebellar tDCS can improve symptoms in these patients over the short term and the long term.

Patients available for this study were randomised to sham (n = 12; mean age, 55.2 years) or real (2 mA; n = 8; mean age, 49.8 years) tDCS. The treatments were applied for 20 minutes 5 days/week for 2 weeks.

Multiple efficacy analyses were carried out at baseline, the end of treatment, and 1 and 3 months after the end of treatment.

At baseline, the patients showed similar values between sham and real treatments for Scale for Assessment and Rating of Ataxia (SARA; 17.6 vs 16.1, respectively), International Cooperative Ataxia Rating Scale (ICARS; 48.3 vs 44.2), 9-hole peg test (9-HPT; 49.6 vs 43.4 s), and 8-m walking test (8-MWT; 9.1 vs 8.4 s).

Over the short term, at end of treatment and at 1 month later, all of the efficacy measures were significantly improved (P < .05) between sham to real treatment (SARA, 17.4 vs 13.2 and 17.5 vs 12.8, respectively; ICARS, 47.6 vs 35.2 and 47.6 vs 34.2; 9-HPT, 51.8 vs 40.5 s and 51.7 vs 39.7 s; 8-MWT: 9.4 vs. 7.7 s and 9.5 vs 7.4 s).

At 3 months after treatment, the SARA and ICARS measures were again significantly improved for real treatment (17.5 vs 12.7 and 47.5 vs 36.8, respectively; P < .05 for both). For the 9-PT and 8-MWT over the long-term period, although the real treatment benefits were maintained, the significance over sham was lost (51.1 vs 41.7 s and 9.5 vs 7.9 s, respectively).

“We found restoration of the cerebellar brain inhibition [on the primary motor cortex], as assessed with a transcranial magnetic stimulation protocol, in a patient who underwent the real stimulation,” noted Dr. Dell’Era.

This has been shown to be impaired for patients with cerebellar ataxia.

“We believe that [anodal tDCS] could be a future therapeutic or rehabilitative approach, because for cerebellar ataxias, and in particular neurodegenerative ataxias, there is no treatment at the moment,” concluded Dr. Dell’Era.

[Presentation title: Sustained Effects of Cerebellar Transcranial Direct Current Stimulation in Patients With Ataxia: A Randomized, Double-Blind, Sham-Controlled Study. Abstract 1056]

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