title: Mild cognitive impairment in Parkinson's disease is improved by transcranial direct current stimulation combined with physical therapy.
abstract: Parkinson's disease (PD) is characterized by both motor and cognitive deficits. In PD, physical exercise has been found to improve physical functioning. Recent studies demonstrated that repeated sessions of transcranial direct current stimulation led to an increased performance in cognitive and motor tasks in patients with PD.
  
  
  
  The present study investigated the effects of anodal transcranial direct current stimulation applied over the dorsolateral prefrontal cortex and combined with physical therapy in PD patients.
  
  
  
  A total of 20 patients with PD were assigned to 1 of 2 study groups: group 1, anodal transcranial direct current stimulation plus physical therapy (n = 10) or group 2, placebo transcranial direct current stimulation plus physical therapy (n = 10). The 2 weeks of treatment consisted of daily direct current stimulation application for 25 minutes during physical therapy. Long-term effects of treatment were evaluated on clinical, neuropsychological, and motor task performance at 3-month follow-up.
  
  
  
  An improvement in motor abilities and a reduction of depressive symptoms were observed in both groups after the end of treatment and at 3-month follow-up. The Parkinson's Disease Cognitive Rating Scale and verbal fluency test performances increased only in the anodal direct current stimulation group with a stable effect at follow-up.
  
  
  
  The application of anodal transcranial direct current stimulation may be a relevant tool to improve cognitive abilities in PD and might be a novel therapeutic strategy for PD patients with mild cognitive impairment. © 2016 International Parkinson and Movement Disorder Society.
authors.affiliation: Neuropsychology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Manenti
authors.affiliation: Neuropsychology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Brambilla
authors.affiliation: Neurology Unit, Centre for Neurodegenerative Disorders, University of Brescia, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Benussi
authors.affiliation: Neuropsychology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Rosini
authors.affiliation: Neuropsychology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cobelli
authors.affiliation: Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Ferrari
authors.affiliation: Neuropsychology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Petesi
authors.affiliation: Neuropsychology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Italo
authors.initials: I
authors.lastname: Orizio
authors.affiliation: Neurology Unit, Centre for Neurodegenerative Disorders, University of Brescia, Brescia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Padovani
authors.affiliation: Neurology Unit, Centre for Neurodegenerative Disorders, University of Brescia, Brescia, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Borroni
authors.affiliation: Neuropsychology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Cotelli
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000209:etiology / Q000628:therapy*; D003131:Combined Modality Therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D017397:Prefrontal Cortex; D065908:Transcranial Direct Current Stimulation / Q000379:methods*
keywords: Frontal lobe; Motor abilities; Noninvasive brain stimulation; Nonpharmacological treatment; tDCS