Abstract Details

Title Transcranial Direct Current Stimulation for Limb-Kinetic Apraxia in Parkinson's Disease – a Randomized, Double-blinded, Sham-controlled Trial

Topic Movement Disorders

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-023

Objective

To examine the effects of transcranial direct current stimulation on limb-kinetic apraxia(LKA) in Parkinson’s disease(PD).

Background Limb-kinetic apraxia is a commonly overlooked phenomenon in PD, characterized as difficulty performing precise and coordinated finger movements. To date, there are no established treatments for this phenomenon, and levodopa medication has been reported to have no effect.

Design/Methods 28 PD patients completed the study. Patients were randomized to two groups; anodal or sham stimulation. For patients assigned to active stimulation, anodal stimulation of the left posterior parietal cortex was performed using 1.5 mA current for 20 minutes. Patients receiving sham stimulation also underwent the session for 20 minutes. The investigators and patients were both blinded to group allocation. Both groups were instructed to perform repetitive manual tasks including buttoning and unbuttoning, handwriting and coin flipping following the stimulation session. The primary outcome measure was time performing sequential buttoning and unbuttoning, and several secondary outcome measures were obtained (e.g., Unified Parkinson's Disease Rating Scale: UPDRS scores, resting motor threshold: RMT, time writing one’s name 10 times, time flipping a coin using each hand, etc.).

Results Mean age in the active and sham group were 73 and 72 years, respectively. Mean MMSE scores were 25 and 26, respectively. Mixed ANOVA was performed and a significant interaction was found between stimulation type and conditions (medication OFF, ON, tDCS immediate and post-tDCS 24 hours). Patients who received active (anodal) stimulation were found to have a significant decrease in sequential buttoning and unbuttoning times immediately following tDCS and at 24 hours, compared to the medication-OFF state (31% and 29% decrease, respectively). No statistically significant findings were found in the sham group.

Conclusions

Anodal tDCS of the left posterior parietal cortex, relevant in praxis, appears to be effective in ameliorating LKA in PD. Therefore, future long-term projects performing serial stimulation sessions seem worthwhile.

Authors/Disclosures
Jung E Park, MD, PhD (Dongguk University Ilsan Hospital) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Mark Hallett, MD, FAAN (National Institutes of Health)	Dr. Hallett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Hallett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. Dr. Hallett has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Brainsway. Dr. Hallett has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for VoxNeuro. Dr. Hallett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for QuantalX. Dr. Hallett has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Hallett has received intellectual property interests from a discovery or technology relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received personal compensation in the range of $500-$4,999 for serving as a Speaker with International Parkinson and Movement Disorder Society. Dr. Hallett has a non-compensated relationship as a Past-President with Functional Neurological Disorder Society that is relevant to AAN interests or activities.

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