Objective: To examine whether a single session of cerebellum and motor cortex (tDCS) stimulation associated with specific training of balance skills could change balance and gait parameters in a person with SCA1

Background: Balance and gait are considered to be relevant in the rehabilitation of people with ataxia. Specific motor skills training, and cerebellar and primary cortex tDCS are non-invasive techniques that have been shown to contribute into functional status of people with SCA. It is interesting to know which parameters will be modified with both simultaneous interventions.

Methods: A person with SCA1, 53 years, 5 years from motor onset, living daily without help, SARA 11, dominant lower limbs ataxia and vestibular disorder,,were stimulated with 20 min anodal cerebellar tDCS 2mA and 20 min anodal M1 tDCS during balance skills training. Changes pre-post stimulation were evaluated with dynamic posturography on Clinical Test of Somatosensory Integration and Balance (CTSIB) and 10m walking test (10mWT) with APDM wearable sensors.

Results: Parametric changes on bipedal balance on CTISB regarding standard values, were observed under the condition of closed eyes on firm surface, reaching standard values for path length (41 m/s2 to 12.8 m/s2) and in open eyes, firm surface jerk (83.1 m/s to 4.88 m/s5). Although parametrics with closed eyes in foam surface were significantly better, these did not reache standard normative close values which could be due to interference of the vestibular way. The parametrics of walking which happens to have changes regarding standard values, were speed: 0,86 m/s to 1.1m/s, 1.1 m/s is considered normal walking speed. The % of double support decreased significantly: 19,41% to 12,1% indicating better monopodal balance and thus better adaptability of the later.

Conclusions: The single session could change balance and gait parameters. More research is needed in order to know if repetitive stimulations could show new changes in the walking and balance, and the permanence of these.

References: Benussi A., Dell’Era V., Cotelli MS., Turla M., Casali C., Padovani A., Borroni B.Long term clinical and neurophysiological effects of cerebellar transcranial direct current stimulation in patients with neurodegenerative ataxia.Brain Stimul. 2017 Mar – Apr;10(2):242-250. Benussi A, Koch G, Cotelli M, Padovani A, Borroni B. Cerebellar transcranial direct current stimulation in patients with ataxia: A double-blind, randomized, sham-controlled study. Mov Disord. 2015 Oct;30(12):1701-5.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/changes-in-balance-and-gait-after-a-single-session-of-combined-cerebellum-and-primary-motor-cortex-transcranial-direct-current-stimulation-tdcs-in-a-person-with-sca1/