Closed-loop brain stimulation can improve Parkinsonian gait disturbance

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K11351
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: Nagoya City University
• Principal Investigator: Ueki Yoshino 名古屋市立大学, 医薬学総合研究院(医学), 教授 (40467478)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: neuromodulation

Outline of Final Research Achievements

Gait disturbance lowers activities of daily living in patients with Parkinson's disease (PD) and related disorders. We recently developed a novel neuromodulation approach using gait-combined closed-loop transcranial electrical stimulation (tES). Here, we tested the efficacy of this intervention in patients with Parkinsonian gait disturbances. Twenty-three patients were randomly assigned to a real intervention group using gait-combined closed loop oscillatory tES over the cerebellum at the frequency of individualized comfortable gait rhythm, and to a sham control group. Ten intervention sessions were completed for all patients and showed that the gait speed and stride length were significantly increased after tES. Moreover, gait symmetry and subjective feelings about freezing were significantly improved. These findings showed that gait-combined closed-loop tES improved Parkinsonian gait disturbances, possibly through the modulation of brain networks generating gait rhythms.

Free Research Field

リハビリテーション医学

Academic Significance and Societal Importance of the Research Achievements

本研究の学術的独自性・独創的な点は、PD関連疾患をネットワーク病態としてとらえ、患者個々人に適応させた最新のニューロモデュレーションを用いたネットワーク介入を行い、その行動学的変化のみならずネットワークに与える効果を非侵襲的脳機能計測法を用いて明らかにするものである。この様なPD関連疾患の歩行障害をネットワーク病態の観点から非侵襲的に介入し、さらに患者個人の脳内リズムに個別化したオーダーメイドリハビリテーションは国内外に例がなく、非常に斬新的である。PDにおける新たなリハビリテーション法として社会的意義も高い。