title: Safety and immediate effect of noninvasive transcranial pulsed current stimulation on gait and balance in Parkinson disease.
abstract: BACKGROUND
  Noninvasive electrical stimulation of the brain (ESB) is being investigated as a valued intervention to enhance motor performance.
  
  
  OBJECTIVE
  To ascertain the safety and ability of transcranial pulsed current stimulation (tPCS) to modulate variables of protective stepping and gait of individuals with Parkinson's disease.
  
  
  METHODS
  Ten patients participated in a pilot study. During the first session, a tPCS delivered current for 20 minutes via a positive electrode placed over the primary motor area (M1). In week 2, participants walked for 20 minutes on a treadmill. In week 3, tPCS and treadmill for 20 minutes were combined. Pre-testing and post-testing of gait and protective stepping were administered, comparing post-intervention (tPCS alone, treadmill alone, tPCS + treadmill) with pre-intervention data. The 3 interventions were compared by calculating the difference between post-intervention and pre-intervention data. A significance level of P < .05 was adopted.
  
  
  RESULTS
  Stride length increased from 102.1 ± 24.4 to 111.2 ± 22.1 cm, and gait velocity increased from 0.90 ± 0.23 to 0.985 ± 0.19 m/s after tPCS. Treadmill or treadmill + tPCS did not result in changes in the studied gait parameters. The tPCS session increased gait velocity and stride length significantly compared with treadmill or tPCS + treadmill. Overall, the number of steps needed to recover balance decreased after tPCS and tPCS + treadmill.
  
  
  CONCLUSIONS
  Noninvasive tPCS over the primary motor cortex had no adverse effects on those with long-standing Parkinson's disease and may lead to acute improvement of gait and balance recovery.
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD 21201, USA. galon@som.umaryland.edu
authors.forename: Gad
authors.initials: G
authors.lastname: Alon
authors.forename: Don A
authors.initials: DA
authors.lastname: Yungher
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Shulman
authors.forename: Mark W
authors.initials: MW
authors.lastname: Rogers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000502:physiology*; D003627:Data Interpretation, Statistical; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D004856:Postural Balance / Q000502:physiology*; D012371:Robotics; D016138:Walking / Q000502:physiology