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Effect of Transcranial Direct Current Stimulation of Motor Cortex in Cerebral Palsy: A Study Protocol
Natália de Almeida Carvalho Duarte1, Luanda André Collange Grecco, Roberta Delasta Lazzari
1Post Doctoral Program in Rehabilitation Sciences (Dr Duarte), Santa Casa de São Paulo, São Paulo, Brazil; Doctoral Program in Rehabilitation Sciences (Ms Lazzari), Nove de Julho University, São Paulo, Brazil; Center of Pediatric Neurostimulation, CENEPE Rehabilitation, and Universidade Federal de São Paulo (Dr Grecco), São Paulo, Brazil; University of Sorocaba (Drs Grecco and Neto), Sorocaba, Brazil; Department of Electronic Information and Bioengineering, Politecnico di Milano, Milan, and IRCCS San Raffaele Pisana, Rome (Dr Galli), Italy; University Center of Anápolis - Uni Evangélica (Dr Oliveira), Anápolis, Goiás, Brazil.
Insights
This study investigated optimal electrode placement for transcranial direct current stimulation (tDCS) combined with treadmill training to improve gait and balance in children with cerebral palsy.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Pediatric Neurology
Background:
- Unilateral spastic cerebral palsy (USCP) affects motor function, particularly gait and balance.
- Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique explored for motor rehabilitation.
- Optimizing tDCS electrode placement is crucial for maximizing therapeutic effects in USCP.
Purpose of the Study:
- To determine the most effective electrode position for tDCS when combined with treadmill training in children with USCP.
- To compare functional outcomes based on different tDCS electrode configurations.
Main Methods:
- A randomized controlled trial involving 30 children with cerebral palsy.
- Three groups received treadmill training: (1) anodal tDCS over the dominant hemisphere's motor cortex, (2) sham tDCS, and (3) anodal tDCS over the injured hemisphere's motor cortex.
- Outcome measures included gait, balance, quality of life, and electromyographic activity.
Main Results:
- The study protocol outlines the investigation of electrode positions for tDCS combined with treadmill training.
- Functional improvements in gait, balance, and quality of life are anticipated outcomes.
- Electromyographic activity changes will be assessed to understand neural correlates.
Conclusions:
- This intervention study protocol aims to identify the best electrode position for tDCS-assisted treadmill training in pediatric cerebral palsy.
- Findings are expected to guide clinical practice for optimizing neuromodulation strategies in USCP rehabilitation.
- The research will contribute to evidence-based approaches for improving motor function in children with cerebral palsy.
Purpose:
To assess the best electrode position of transcranial direct current stimulation combined with treadmill training in children with unilateral spastic cerebral palsy.
Methods:
Thirty children with cerebral palsy were randomly allocated to 3 groups: (1) treadmill training combined with anodal electrode positioned over the primary motor cortex in the region of the dominant hemisphere and the cathode positioned in the supraorbital region contralateral to anode; (2) sham anodal transcranial direct current stimulation over the primary motor cortex and sham cathode over the contralateral supraorbital region combined with treadmill training; (3) treadmill training combined with the anodal electrode positioned over the primary motor cortex in the region of the injured hemisphere and the cathode positioned contralateral to anode over the primary motor cortex. Evaluations of gait, balance, quality of life, and electromyographic activity were performed.
Discussion:
This is the protocol for an intervention study investigating electrode position to achieve improved function.
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