Treatment with anodal cerebellar transcranial direct current stimulation (ctDCS) reduces motor and cognitive symptoms in patients with Friedreich ataxia (FA), a new study published in Movement Disorders found. It likely does so “by restoring the neocortical inhibition normally exerted by cerebellar structures,” the authors said, adding that the study “provides class I evidence” that the procedure is safe and effective.
To investigate whether ctDCS can reduce ataxic and cognitive symptoms in patients with FA and assess the effects of the procedure on the activity of the secondary somatosensory cortex, a team of researchers led by Xavier De Tiège, MD, PhD, from Université libre de Bruxelles in Belgium conducted a single-blind, randomized, sham-controlled study in 24 patients with the disease.
Read more about the symptoms of FA
Participants received anodal ctDCS or a sham procedure 5 days a week for 1 week, lasting 20 minutes each day. The density of the current was 0.057 mA/cm2.
Each participant underwent a clinical evaluation and an evaluation of the activity of the secondary somatosensory cortex before and after the procedure.
The results showed that anodal ctDCS led to significant improvements in the Scale for the Assessment and Rating of Ataxia and the cerebellar cognitive affective syndrome scale compared to the sham protocol.
ctDCS also led to a significant decline in functional magnetic resonance imaging signal at the secondary somatosensory cortex contralateral to tactile stimulation compared to the sham protocol.
“One week of treatment with anodal ctDCS reduces motor and cognitive symptoms in individuals with [FA]”, the researchers wrote, “likely by restoring the neocortical inhibition normally exerted by cerebellar structures.”
FA is an inherited neurodegenerative ataxia characterized by progressive discoordination of the extremities and trunk, muscle weakness and spasticity, difficulty walking, cardiomyopathy, and dysarthria.
ctDCS is a noninvasive technique for inducing functional motor and nonmotor changes in the cerebellum.
Naeije G, Rovai A, Destrebecq V, Trotta N, De Tiège X. Anodal cerebellar transcranial direct current stimulation reduces motor and cognitive symptoms in Friedreich’s ataxia: a randomized, sham-controlled trial. Mov Disord. Published online June 13, 2023. doi:10.1002/mds.29453