Transcranial random noise stimulation over the primary motor cortex in PD-MCI patients: a crossover, randomized, sham-co
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NEUROLOGY AND PRECLINICAL NEUROLOGICAL STUDIES - ORIGINAL ARTICLE
Transcranial random noise stimulation over the primary motor cortex in PD‑MCI patients: a crossover, randomized, sham‑controlled study Roberto Monastero1 · Roberta Baschi1 · Alessandra Nicoletti2 · Laura Pilati1 · Lorenzo Pagano1 · Calogero Edoardo Cicero2 · Mario Zappia2 · Filippo Brighina1 Received: 15 May 2020 / Accepted: 14 September 2020 © The Author(s) 2020
Abstract Mild cognitive impairment (MCI) is a very common non-motor feature of Parkinson’s disease (PD) and the non-amnestic single-domain is the most frequent subtype. Transcranial random noise stimulation (tRNS) is a non-invasive technique, which is capable of enhancing cortical excitability. As the main contributor to voluntary movement control, the primary motor cortex (M1) has been recently reported to be involved in higher cognitive functioning. The aim of this study is to evaluate the effects of tRNS applied over M1 in PD-MCI patients in cognitive and motor tasks. Ten PD-MCI patients, diagnosed according to the Movement Disorder Society, Level II criteria for MCI, underwent active (real) and placebo (sham) tRNS single sessions, at least 1 week apart. Patients underwent cognitive (Digit Span Forward and Backward, Digit Symbol, Visual Search, Letter Fluency, Stroop Test) and motor assessments (Unified Parkinson’s Disease Rating Scale [UPDRS-ME], specific timed trials for bradykinesia, 10-m walk and Timed up and go tests) before and after each session. A significant improvement in motor ability (UPDRS-ME and lateralized scores, ps from 0.049 to 0.003) was observed after real versus sham tRNS. On the contrary, no significant differences were found in other motor tasks and cognitive assessment both after real and sham stimulations. These results confirm that tRNS is a safe and effective tool for improving motor functioning in PD-MCI. Future studies using a multisession tRNS applied over multitargeted brain areas (i.e., dorsolateral prefrontal cortex and M1) are required to clarify the role of tRNS regarding rehabilitative intervention in PD. Keywords Parkinson’s disease · Cognitive impairment · Motor cortex · Transcranial random noise stimulation
Introduction Mild cognitive impairment in Parkinson’s Disease (PDMCI) is rather prevalent in PD, accounting for over 30% of patients (Litvan et al. 2011; Monastero et al. 2018). In 2012 a task force of the Movement Disorder Society (MDS) proposed a standardized set of diagnostic criteria for PD-MCI which improved diagnosis and reduced the heterogeneity of Roberto Monastero and Roberta Baschi have equally contributed. * Roberto Monastero [email protected]; [email protected] 1
Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Section of Neurosciences, University of Catania, Catania, Italy
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results regarding the determinants and predictors of cognitive
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