title: Cerebellar and Motor Cortical Transcranial Stimulation Decrease Levodopa-Induced Dyskinesias in Parkinson's Disease.
abstract: Transcranial direct current stimulation (tDCS) is a non-invasive technique for inducing prolonged functional changes in the human cerebral cortex. This simple and safe neurostimulation technique for modulating motor functions in Parkinson's disease could extend treatment option for patients with movement disorders. We assessed whether tDCS applied daily over the cerebellum (cerebellar tDCS) and motor cortex (M1-tDCS) improves motor and cognitive symptoms and levodopa-induced dyskinesias in patients with Parkinson's disease (PD). Nine patients (aged 60-85 years; four women; Hoehn & Yahr scale score 2-3) diagnosed as having idiopathic PD were recruited. To evaluate how tDCS (cerebellar tDCS or M1-tDCS) affects motor and cognitive function in PD, we delivered bilateral anodal (2 mA, 20 min, five consecutive days) and sham tDCS, in random order, in three separate experimental sessions held at least 1 month apart. In each session, as outcome variables, patients underwent the Unified Parkinson's Disease Rating Scale (UPDRS III and IV) and cognitive testing before treatment (baseline), when treatment ended on day 5 (T1), 1 week later (T2), and then 4 weeks later (T3), at the same time each day. After patients received anodal cerebellar tDCS and M1-tDCS for five days, the UPDRS IV (dyskinesias section) improved (p < 0.001). Conversely, sham tDCS, cerebellar tDCS, and M1-tDCS left the other variables studied unchanged (p > 0.05). Despite the small sample size, our preliminary results show that anodal tDCS applied for five consecutive days over the motor cortical areas and cerebellum improves parkinsonian patients' levodopa-induced dyskinesias.
authors.affiliation: Fondazione IRCCS Ca' Granda, Milan, Italy.|Università degli Studi di Milano, Milan, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Ferrucci
authors.affiliation: Fondazione IRCCS Ca' Granda, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cortese
authors.affiliation: Spedali Civili di Brescia, Università degli Studi di Brescia, Brescia, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Bianchi
authors.affiliation: Fondazione IRCCS Ca' Granda, Milan, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Pittera
authors.affiliation: Spedali Civili di Brescia, Università degli Studi di Brescia, Brescia, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Turrone
authors.affiliation: Fondazione IRCCS Ca' Granda, Milan, Italy.|Università degli Studi di Pisa, Pisa, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Bocci
authors.affiliation: Spedali Civili di Brescia, Università degli Studi di Brescia, Brescia, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Borroni
authors.affiliation: Fondazione IRCCS Ca' Granda, Milan, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vergari
authors.affiliation: Fondazione IRCCS Ca' Granda, Milan, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Cogiamanian
authors.affiliation: Fondazione IRCCS Ca' Granda, Milan, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ardolino
authors.affiliation: Fondazione IRCCS Ca' Granda, Milan, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Di Fonzo
authors.affiliation: Spedali Civili di Brescia, Università degli Studi di Brescia, Brescia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Padovani
authors.affiliation: Fondazione IRCCS Ca' Granda, Milan, Italy. alberto.priori@unimi.it.|Università degli Studi di Milano, Milan, Italy. alberto.priori@unimi.it.|III Clinica Neurologica, Polo Ospedaliero San Paolo, Milan, Italy. alberto.priori@unimi.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Priori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000978:Antiparkinson Agents / Q000009:adverse effects; D002531:Cerebellum / Q000502:physiology*; D004409:Dyskinesia, Drug-Induced / Q000628:therapy*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology*; D010300:Parkinson Disease / Q000188:drug therapy; D012720:Severity of Illness Index; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Cerebellar tDCS; Cerebellum; Levodopa-induced dyskinesias; Parkinson; tDCS