Long term at-home treatment with transcranial direct current stimulation (tDCS) improves symptoms of cerebellar ataxia: a case report.
Giuseppina Pilloni, Michael Shaw, Charles Feinberg and 4 others
PMID 30890162WHAT IT FOUND
One patient with progressive cerebellar ataxia completed 59 at-home tDCS sessions alongside cognitive games and prescribed exercise.
The report describes faster pegboard and walking tests and less fatigue, but cannot separate tDCS from the other treatments.
Key findings
01The patient completed an in-clinic tDCS session and 59 remotely supervised at-home sessions, with no treatment-limiting adverse events reported.
02The paper reports 25-FWT 7% faster, Timed Up and Go 9.88 s versus 11.90 s at baseline, and pegboard 18% and 19% faster in dominant and non-dominant hands, but tDCS was given with cognitive training and physical exercise.
03Fatigue Severity Scale scores changed from 22 to 14 and PROMIS-Fatigue from 14 to 10, while cognitive follow-up showed no notable change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a single open-label case report, so it cannot show that tDCS works. The patient received tDCS together with computer cognitive training, prescribed physical exercise and her usual daily home rehabilitation, so the contribution of any one component cannot be separated. No control group or sham condition was used, so placebo effects cannot be ruled out. The study did not use the Scale for Assessment and Rating of Ataxia, a specific measure of ataxia symptoms. The reported Timed Up and Go improvement is inconsistent with the table value at the 60th session, so the timing and stability of that change are unclear. Findings from one patient cannot be generalised to other people with cerebellar ataxia.
The easy way to misread this
Do not conclude that tDCS alone improved this patient. She received tDCS together with computer cognitive training and prescribed physical exercise, and the study was an open-label single case report, so no single component can be separated.