Generalizing remotely supervised transcranial direct current stimulation (tDCS): feasibility and benefit in Parkinson's disease.
Bryan Dobbs, Natalie Pawlak, Milton Biagioni and 6 others
PMID 30522497WHAT IT FOUND
Ten home tDCS sessions paired with cognitive training were feasible in 16 people with Parkinson's disease.
Fatigue, sleep, visual learning and reaction time scores did not show a clear change; negative affect scores decreased, but this was a small pilot.
Key findings
01Sixteen participants with Parkinson's disease were enrolled, and fifteen completed all ten remotely supervised tDCS sessions paired with cognitive training.
02Adverse events were mostly tingling and burning at the electrode site, with reported frequencies of 43.42% and 28.95% over 152 sessions, and were mild and resolved after sessions.
03Preliminary efficacy was mixed: negative affect scores decreased from 16.4 to 13.8 with a reported p value of 0.01, while fatigue, sleep, visual learning and reaction time scores had reported p values of 0.10, 0.16, 0.50, 0.19 and 0.08.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a small open-label feasibility study with no control group, so it cannot show that tDCS caused any change. Sixteen participants were enrolled, fifteen completed all ten sessions, and one stopped after two sessions. The participants received tDCS together with computerized cognitive training, so the contribution of tDCS alone cannot be separated. Not all participants completed all outcome measures because of disability and later addition of assessments; some analyses included only 7, 8, 11, 12 or 13 participants. The sample was 80% male and 100% white, with mean education 17.5 years and mean WRAT-3 117.5, so it may not represent broader Parkinson's populations. The efficacy table marks p 0.01 as significant but also says statistical significance at p > 0.05, so the significance label is unclear. The UPDRS was administered at baseline and follow-up, but no motor outcome change is reported in the supplied text.
The easy way to misread this
Do not read the decrease in negative affect as proof that tDCS works for Parkinson's. The participants received ten tDCS sessions together with computerized cognitive training, and this was a small open-label feasibility study without a control group.