Brief protocol to improve ataxia symptoms via cerebello-spinal direct current stimulation during gait training

Investigate whether a brief protocol of cerebello-spinal direct current stimulation (csDCS) associated with gait training can improve functional mobility, cerebellar ataxia severity, and balance in cerebellar ataxia volunteers.

A randomized, triple-blind, sham-controlled, bi-center clinical trial was conducted. 30 volunteers with cerebellar ataxia were randomized into two groups to receive five sessions of csDCS (anodal, 35 cm², in the cerebellum and cathodal, 48 cm², in spinal lumbar enlargement, 2 mA during 25 min), or sham (the same protocol, but lasting 30 s) during gait training (25 min). The volunteers were assessed through the Timed up-and-go test, Scale for the Assessment and Rating of Ataxia, and miniBESt test at baseline and after the fifth day of the intervention.

csDCS during gait training improved functional mobility (mean difference -6.3 s; 95% CI -11.5 to -1.2; U = 2.46, p = 0.01) with a large effect size (d = -0.87 (95%CI:-1.61 to -0.12)), cerebellar ataxia severity (mean difference -1.3 points; 95% CI -2.13 to -0.47; U = -2.78; p < 0.01), with a large effect size (d = -1.17 (95%CI: -1.94 to -0.39)), and balance (mean difference 3.5 points; 95% CI 1.1 to 5.9; t(28) = 3.88, p = 0.001) with a large effect size (d = -1.10 (95%CI: -1.87 to -0.33)).

The csDCS during gait training improved the functional mobility, cerebellar ataxia severity, and balance in a large effect size after a short protocol of five sessions.

A brief protocol of csDCS associated with gait training may improve functional mobility, cerebellar ataxia severity and balance.

NCT03703830 - https://clinicaltrials.gov/study/NCT03703830.