Estudo piloto de validação clínica de uma montagem de multieletrodos não- invasiva para estimulação elétrica profunda em pacientes com doença de Parkinson

Abstract

Parkinson's disease (PD) can alter the gait, cognitive symptoms and depression. Changes in the excitability and connectivity of the cortex with the caudate nucleus have been associated with a variety of neurological disorders that cause cognitive impairment, depression, and biological gait dysfunction. tDCS (transcranial direct current stimulation) has demonstrated an effect on gait, cognition and motivation in PD. Innovative techniques such as periorbital assembly with high definition HD-tDCS (high definition - tDCS) microelectrodes have the potential to project the electric field to the striated nucleus. OBJECTIVE: In this pilot study, we sought to clinically demonstrate the possibility of projecting the electrical field into deep brain structures with the HD-tDCS periorbital montage. METHODOLOGY: We used a crossover, randomized, double-blind, placebo-controlled experimental design. For this purpose, 14 Individuals were randomized and underwent 4 stimulation sessions during one week (1 session/day X 4 days). Gait and balance were assessed with standardized tests, and motor fluctuation and depression were assessed using scales. Individuals were invited to perform a new intervention after 8 weeks. RESULTS: A total of 10 individuals completed the two proposed treatment cycles (placebo and intervention). The assembly was safe and tolerant. There was significant improvement for experimental stimulation on the depression scale. Experimental stimulation also showed a trend toward statistically non-significant improvement in subjects' task gait outcomes during experimental stimulation after 30 days. Furthermore, experimental stimulation showed a trend toward improvement in all gait tests, symptom fluctuation scale, and tDCS satisfaction questionnaire. CONCLUSION: Our results suggest that the proposed assembly was capable of producing an electric field in subcortical areas of the brain, involved in the genesis of PD symptoms, as indicated by the preliminary electrical modeling study. Increasing the sample may confirm the observed trend. Expanding the electrical modeling study will be important to relate the results to the effect on different structures at the base of the Encephalon.