Combination of anodal tDCS of the cerebellum with a goal-oriented motor training to treat cervical dystonia: a pilot case series.

cerebellar stimulation cervical dystonia motor training neuromodulation non-invasive brain stimulation rehabilitation transcranial direct current stimulation

Journal

Frontiers in neurology
ISSN: 1664-2295
Titre abrégé: Front Neurol
Pays: Switzerland
ID NLM: 101546899

Informations de publication

Date de publication:
2024
Historique:
received: 03 02 2024
accepted: 16 04 2024
medline: 15 5 2024
pubmed: 15 5 2024
entrez: 15 5 2024
Statut: epublish

Résumé

Transcranial Direct Current Stimulation (tDCS) of the cerebellum shows promise for the treatment of dystonia. Specific motor rehabilitation programs have also been developed in this context. However, the combination of these two approaches has not yet been evaluated to determine their therapeutic potential. We report a series of 5 patients with cervical dystonia (CD) poorly controlled by botulinum toxin injections. They were initially treated by a protocol of repeated daily sessions (for 3 or 5 days) of cerebellar anodal tDCS (cer-atDCS) applied alone. In a second time, additional protocols of cer-atDCS were performed in combination with a program of goal-oriented motor training exercises (Mot-Training), specifically developed for the treatment of CD. The clinical impact of the procedures was assessed on the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Compared to baseline, the maximum percentage of TWSTRS total score improvement was 37% on average after cer-atDCS performed alone ( The combination of cer-atDCS with Mot-Training produced a greater and more prolonged improvement than the application of cer-atDCS alone. Such a combined therapeutic procedure is easy to perform and opens important perspectives in the long-term treatment of CD. These results remain to be confirmed by a randomized sham-controlled trial on a larger sample.

Sections du résumé

Background UNASSIGNED
Transcranial Direct Current Stimulation (tDCS) of the cerebellum shows promise for the treatment of dystonia. Specific motor rehabilitation programs have also been developed in this context. However, the combination of these two approaches has not yet been evaluated to determine their therapeutic potential.
Methods UNASSIGNED
We report a series of 5 patients with cervical dystonia (CD) poorly controlled by botulinum toxin injections. They were initially treated by a protocol of repeated daily sessions (for 3 or 5 days) of cerebellar anodal tDCS (cer-atDCS) applied alone. In a second time, additional protocols of cer-atDCS were performed in combination with a program of goal-oriented motor training exercises (Mot-Training), specifically developed for the treatment of CD. The clinical impact of the procedures was assessed on the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).
Results UNASSIGNED
Compared to baseline, the maximum percentage of TWSTRS total score improvement was 37% on average after cer-atDCS performed alone (
Conclusion UNASSIGNED
The combination of cer-atDCS with Mot-Training produced a greater and more prolonged improvement than the application of cer-atDCS alone. Such a combined therapeutic procedure is easy to perform and opens important perspectives in the long-term treatment of CD. These results remain to be confirmed by a randomized sham-controlled trial on a larger sample.

Identifiants

pubmed: 38746658
doi: 10.3389/fneur.2024.1381390
pmc: PMC11091337
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1381390

Informations de copyright

Copyright © 2024 Bleton, Cossé, Caloc’h, Suarez Moreno, Diverres, Derkinderen, Nizard, Lefaucheur and Nguyen.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Auteurs

Jean-Pierre Bleton (JP)

Neurology Department, Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France.

Charlotte Cossé (C)

Unité de Stimulation Transcrânienne, Clinique Bretéché, Groupe Elsan, Nantes, France.

Tiphanie Caloc'h (T)

Unité de Stimulation Transcrânienne, Clinique Bretéché, Groupe Elsan, Nantes, France.

Alcira Suarez Moreno (A)

Unité de Stimulation Transcrânienne, Clinique Bretéché, Groupe Elsan, Nantes, France.

Elisabeth Diverres (E)

Unité de Stimulation Transcrânienne, Clinique Bretéché, Groupe Elsan, Nantes, France.

Pascal Derkinderen (P)

Service de Neurologie, CHU de Nantes, Nantes, France.

Julien Nizard (J)

Service Douleur, Soins Palliatifs et de Support et UIC22, Hôpital Laennec, CHU, Nantes, France.
EA 4391, Équipe ENT (Nerve Excitability and Therapeutics), Université Paris-Est Créteil, Créteil, France.

Jean-Pascal Lefaucheur (JP)

EA 4391, Équipe ENT (Nerve Excitability and Therapeutics), Université Paris-Est Créteil, Créteil, France.
Unité de Neurophysiologie Clinique, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France.

Jean-Paul Nguyen (JP)

Unité de Stimulation Transcrânienne, Clinique Bretéché, Groupe Elsan, Nantes, France.

Classifications MeSH