title: Multiday Transcranial Direct Current Stimulation Causes Clinically Insignificant Changes in Childhood Dystonia: A Pilot Study.
abstract: Abnormal motor cortex activity is common in dystonia. Cathodal transcranial direct current stimulation may alter cortical activity by decreasing excitability while anodal stimulation may increase motor learning. Previous results showed that a single session of cathodal transcranial direct current stimulation can improve symptoms in childhood dystonia. Here we performed a 5-day, sham-controlled, double-blind, crossover study, where we measured tracking and muscle overflow in a myocontrol-based task. We applied cathodal and anodal transcranial direct current stimulation (2 mA, 9 minutes per day). For cathodal transcranial direct current stimulation (7 participants), 3 subjects showed improvements whereas 2 showed worsening in overflow or tracking error. The effect size was small (about 1% of maximum voluntary contraction) and not clinically meaningful. For anodal transcranial direct current stimulation (6 participants), none showed improvement, whereas 5 showed worsening. Thus, multiday cathodal transcranial direct current stimulation reduced symptoms in some children but not to a clinically meaningful extent, whereas anodal transcranial direct current stimulation worsened symptoms. Our results do not support transcranial direct current stimulation as clinically viable for treating childhood dystonia.
authors: Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA.
authors: Nasir H
authors: NH
authors: Bhanpuri
authors: Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA.
authors: Matteo
authors: M
authors: Bertucco
authors: Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA.
authors: Scott J
authors: SJ
authors: Young
authors: Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA.
authors: Annie A
authors: AA
authors: Lee
authors: Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA Department of Neurology, University of Southern California and Children's Hospital Los Angeles, Los Angeles, CA, USA Division of Neurology, Children's Hospital Los Angeles, Los Angeles, CA, USA Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA terry@sangerlab.net.
authors: Terence D
authors: TD
authors: Sanger
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology / Q000628:therapy; D002648:Child; D018592:Cross-Over Studies; D004311:Double-Blind Method; D020821:Dystonic Disorders / Q000503:physiopathology* / Q000628:therapy*; D004576:Electromyography; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009044:Motor Cortex / Q000503:physiopathology*; D018482:Muscle, Skeletal / Q000503:physiopathology; D010865:Pilot Projects; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: cerebral palsy; dystonia; electromyogram; overflow; transcranial direct current stimulation