title: Long term clinical and neurophysiological effects of cerebellar transcranial direct current stimulation in patients with neurodegenerative ataxia.
abstract: Neurodegenerative cerebellar ataxias represent a group of disabling disorders for which we currently lack effective therapies. Cerebellar transcranial direct current stimulation (tDCS) is a non-invasive technique, which has been demonstrated to modulate cerebellar excitability and improve symptoms in patients with cerebellar ataxias.
  
  
  
  The present study investigated whether a two-weeks' treatment with cerebellar anodal tDCS could improve symptoms in patients with neurodegenerative cerebellar ataxia and could modulate cerebello-motor connectivity, at short and long term.
  
  
  
  We performed a double-blind, randomized, sham controlled trial with cerebellar tDCS (5 days/week for 2 weeks) in twenty patients with ataxia. Each patient underwent a clinical evaluation pre- and post-anodal tDCS or sham stimulation. A follow-up evaluation was performed at one and three months. Cerebello-motor connectivity was evaluated using transcranial magnetic stimulation (TMS) at baseline and at follow-up.
  
  
  
  Patients who underwent anodal tDCS showed a significant improvement in all performance scores (scale for the assessment and rating of ataxia, international cooperative ataxia rating scale, 9-hole peg test, 8-m walking time) and in cerebellar brain inhibition compared to patients who underwent sham stimulation.
  
  
  
  A two-weeks' treatment with anodal cerebellar tDCS improves symptoms in patients with ataxia and restores physiological cerebellar brain inhibition pathways. Cerebellar tDCS might represent a promising future therapeutic and rehabilitative approach in patients with neurodegenerative ataxia.
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Benussi
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Dell'Era
authors.affiliation: Neurology Unit, Valle Camonica Hospital, Esine, Brescia, Italy.
authors.forename: Maria Sofia
authors.initials: MS
authors.lastname: Cotelli
authors.affiliation: Neurology Unit, Valle Camonica Hospital, Esine, Brescia, Italy.
authors.forename: Marinella
authors.initials: M
authors.lastname: Turla
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, University "La Sapienza", Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Casali
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Padovani
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Electronic address: bborroni@inwind.it.
authors.forename: Barbara
authors.initials: B
authors.lastname: Borroni
mesh_terms: D000328:Adult; D000368:Aged; D001259:Ataxia / Q000503:physiopathology* / Q000628:therapy*; D002531:Cerebellum / Q000502:physiology*; D004311:Double-Blind Method; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology; D019636:Neurodegenerative Diseases / Q000503:physiopathology* / Q000628:therapy*; D013997:Time Factors; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D050781:Transcranial Magnetic Stimulation / Q000379:methods; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology
keywords: Cerebellar ataxia; Cerebellar stimulation; Transcranial direct current stimulation