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Transcranial Pulsed Current Stimulation (tPCS) in Parkinson’s Disease: A Pilot Trial

Published online by Cambridge University Press:  28 February 2025

Dinkar Kulshreshtha ,
Olivia Samotus Open the ORCID record for Olivia Samotus [Opens in a new window] ,
Yokesh Tamilselvam ,
Jacky Ganguly Open the ORCID record for Jacky Ganguly [Opens in a new window] ,
Dorian Aur  and
Mandar Jog Open the ORCID record for Mandar Jog [Opens in a new window]
Dinkar Kulshreshtha
Affiliation:
Movement Disorder Centre, London Health Sciences Centre, Western University, London, ON, Canada Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
Olivia Samotus
Affiliation:
Movement Disorders Centre, University Hospital, London, ON, Canada
Yokesh Tamilselvam
Affiliation:
Canadian Surgical Technologies and Advanced Robotics (CSTAR), Department of Electrical and Computer Engineering, Western University, London, ON, Canada
Jacky Ganguly
Affiliation:
Movement Disorder Centre, London Health Sciences Centre, Western University, London, ON, Canada
Dorian Aur
Affiliation:
Movement Disorder Centre, London Health Sciences Centre, Western University, London, ON, Canada
Mandar Jog*
Affiliation:
Movement Disorder Centre, London Health Sciences Centre, Western University, London, ON, Canada
*
Corresponding author: Mandar Jog; Email: [email protected]
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Abstract

Background:

Noninvasive stimulation techniques are a promising therapy due to the ease of administration and minimal side effects. We investigated the clinical, electrophysiological and side effects of transcranial pulsed current stimulation (tPCS) in patients with Parkinson’s disease (PD).

Materials and Methods:

Ten PD patients were called at monthly intervals in the OFF levodopa state. Patients received active tPCS for 20 minutes in the first visit and sham stimulation for 20 minutes in the second and were assessed for the levodopa response in the third. Clinical and bradykinesia scoring and gait and tremor analysis were done before and after stimulation/sham/levodopa in each visit. Scalp electroencephalography (EEG) was recorded for quantitative analysis during each visit. The interventions were compared between pre- and post-intervention.

Results:

A significant improvement with levodopa as compared to active and sham tPCS was seen in clinical scores. Upper limb postural tremor severity (z-score = −2.410, p = 0.016) and the stride velocity variability during post active stimulation improved by 20.7% compared to post sham stimulation though the difference was statistically non-significant. KINARM testing showed a statistically significant difference in the reaction time (p = 0.036) when comparing pre- and post-tPCS active stimulation. EEG recording showed a transitory increase of electrical activity after tPCS, with the most significant increase seen in alpha bandpower (p = 7.95*10-07; z score: −4.93).

Conclusions:

tPCS was well tolerated in all patients. With minimal side effects, ease of administration and mild improvement in the electrophysiological parameters assessed, tPCS can be an alternative therapeutic option in patients with PD.

Résumé

RÉSUMÉ

La stimulation transcrânienne à courant pulsé dans le traitement de la maladie de Parkinson : un essai pilote.

Contexte :

Les techniques de stimulation non effractives constituent un traitement prometteur, car elles sont faciles à administrer et produisent peu d’effets secondaires. Nous avons évalué les effets cliniques, électrophysiologiques et secondaires de la stimulation transcrânienne à courant pulsé (STCP) chez des patients atteints de la maladie de Parkinson (MP).

Méthode :

Après leur recrutement, 10 patients atteints de la MP devaient se présenter au centre de recherche à des intervalles d’un mois en état « OFF » de lévodopa. Ils ont été soumis à une STCP active pendant 20 minutes au cours de la première visite, à une stimulation fictive pendant 20 minutes au cours de la deuxième et à l’administration de lévodopa pour évaluer la réponse des sujets au médicament au cours de la troisième visite. Une analyse des scores cliniques et de la bradykinésie, de la démarche et des tremblements a été réalisée avant et après chacune de ces interventions. Au cours de chaque visite, une électroencéphalographie de surface (EEG) a été réalisée aux fins d’analyse quantitative. Il y a eu comparaison des résultats avant et après les interventions.

Résultats :

Une amélioration importante des scores cliniques a été constatée en ce qui a trait à la prise de lévodopa par rapport à la STCP active et à la STCP fictive. Une diminution sensible de la gravité des tremblements d’attitude des membres supérieurs (score Z = -2,410; p = 0,016) et une nette amélioration de la variabilité de la vitesse de foulée (amélioration : 20,7 %) ont été observées après la STCP active par rapport à la STCP fictive. Les tests réalisés à l’aide du robot KINARM ont révélé une différence statistiquement significative (p = 0,036) entre les résultats obtenus avant et après la STCP active en ce qui a trait au temps de réaction. L’enregistrement par EEG a montré une augmentation transitoire de l’activité électrique après la STCP, et la hausse la plus importante a été enregistrée dans la bande de fréquence alpha (p = 7,95 x 10-07; valeur de Z : -4,93).

Conclusion :

La STCP a été bien tolérée chez tous les patients. En raison de ses effets secondaires minimes, de sa facilité d’administration et de l’amélioration légère des paramètres électrophysiologiques évalués, la STCP peut constituer une solution de rechange thérapeutique chez les patients atteints de la MP.

Keywords

Parkinson’s diseasetranscranial pulsed current stimulationkinematicsgait analysis
Type
Original Article
Information
Canadian Journal of Neurological Sciences , First View , pp. 1 - 9
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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