Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease
Identifieur interne : 000219 ( Istex/Corpus ); précédent : 000218; suivant : 000220Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease
Auteurs : Felipe Fregni ; Paulo S. Boggio ; Marcelo C. Santos ; Moises Lima ; Adriana L. Vieira ; Sergio P. Rigonatti ; M. Teresa A. Silva ; Egberto R. Barbosa ; Michael A. Nitsche ; Alvaro Pascual-LeoneSource :
- Movement Disorders [ 0885-3185 ] ; 2006-10.
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- KwdEn :
Abstract
Electrical stimulation of deep brain structures, such as globus pallidus and subthalamic nucleus, is widely accepted as a therapeutic tool for patients with Parkinson's disease (PD). Cortical stimulation either with epidural implanted electrodes or repetitive transcranial magnetic stimulation can be associated with motor function enhancement in PD. We aimed to study the effects of another noninvasive technique of cortical brain stimulation, transcranial direct current stimulation (tDCS), on motor function and motor‐evoked potential (MEP) characteristics of PD patients. We tested tDCS using different electrode montages [anodal stimulation of primary motor cortex (M1), cathodal stimulation of M1, anodal stimulation of dorsolateral prefrontal cortex (DLPFC), and sham‐stimulation] and evaluated the effects on motor function—as indexed by Unified Parkinson's Disease Rating Scale (UPDRS), simple reaction time (sRT) and Purdue Pegboard test—and on corticospinal motor excitability (MEP characteristics). All experiments were performed in a double‐blinded manner. Anodal stimulation of M1 was associated with a significant improvement of motor function compared to sham‐stimulation in the UPDRS (P < 0.001) and sRT (P = 0.019). This effect was not observed for cathodal stimulation of M1 or anodal stimulation of DLPFC. Furthermore, whereas anodal stimulation of M1 significantly increased MEP amplitude and area, cathodal stimulation of M1 significantly decreased them. There was a trend toward a significant correlation between motor function improvement after M1 anodal–tDCS and MEP area increase. These results confirm and extend the notion that cortical brain stimulation might improve motor function in patients with PD. © 2006 Movement Disorder Society
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DOI: 10.1002/mds.21012
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Santos</name><affiliation><mods:affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Lima, Moises" sort="Lima, Moises" uniqKey="Lima M" first="Moises" last="Lima">Moises Lima</name><affiliation><mods:affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Vieira, Adriana L" sort="Vieira, Adriana L" uniqKey="Vieira A" first="Adriana L." last="Vieira">Adriana L. 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Silva</name><affiliation><mods:affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Barbosa, Egberto R" sort="Barbosa, Egberto R" uniqKey="Barbosa E" first="Egberto R." last="Barbosa">Egberto R. Barbosa</name><affiliation><mods:affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Nitsche, Michael A" sort="Nitsche, Michael A" uniqKey="Nitsche M" first="Michael A." last="Nitsche">Michael A. Nitsche</name><affiliation><mods:affiliation>Department of Clinical Neurophysiology, Georg August University, Goettingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Pascual Eone, Alvaro" sort="Pascual Eone, Alvaro" uniqKey="Pascual Eone A" first="Alvaro" last="Pascual-Leone">Alvaro Pascual-Leone</name><affiliation><mods:affiliation>Harvard Center for Non‐Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2006-10">2006-10</date><biblScope unit="vol">21</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1693">1693</biblScope><biblScope unit="page" to="1702">1702</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">8E9F0F54FAEB6C66A66CC89C72020DE06A096B6B</idno><idno type="DOI">10.1002/mds.21012</idno><idno type="ArticleID">MDS21012</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>brain DC polarization</term><term>cortical stimulation</term><term>motor function</term><term>transcranial direct current stimulation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Electrical stimulation of deep brain structures, such as globus pallidus and subthalamic nucleus, is widely accepted as a therapeutic tool for patients with Parkinson's disease (PD). Cortical stimulation either with epidural implanted electrodes or repetitive transcranial magnetic stimulation can be associated with motor function enhancement in PD. We aimed to study the effects of another noninvasive technique of cortical brain stimulation, transcranial direct current stimulation (tDCS), on motor function and motor‐evoked potential (MEP) characteristics of PD patients. We tested tDCS using different electrode montages [anodal stimulation of primary motor cortex (M1), cathodal stimulation of M1, anodal stimulation of dorsolateral prefrontal cortex (DLPFC), and sham‐stimulation] and evaluated the effects on motor function—as indexed by Unified Parkinson's Disease Rating Scale (UPDRS), simple reaction time (sRT) and Purdue Pegboard test—and on corticospinal motor excitability (MEP characteristics). All experiments were performed in a double‐blinded manner. Anodal stimulation of M1 was associated with a significant improvement of motor function compared to sham‐stimulation in the UPDRS (P < 0.001) and sRT (P = 0.019). This effect was not observed for cathodal stimulation of M1 or anodal stimulation of DLPFC. Furthermore, whereas anodal stimulation of M1 significantly increased MEP amplitude and area, cathodal stimulation of M1 significantly decreased them. There was a trend toward a significant correlation between motor function improvement after M1 anodal–tDCS and MEP area increase. These results confirm and extend the notion that cortical brain stimulation might improve motor function in patients with PD. © 2006 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Felipe Fregni MD, PhD</name><affiliations><json:string>Harvard Center for Non‐Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA</json:string></affiliations></json:item><json:item><name>Paulo S. Boggio MSc</name><affiliations><json:string>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</json:string><json:string>Neuroscience Department, Mackenzie University, Sao Paulo, Brazil</json:string></affiliations></json:item><json:item><name>Marcelo C. Santos</name><affiliations><json:string>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</json:string></affiliations></json:item><json:item><name>Moises Lima</name><affiliations><json:string>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</json:string></affiliations></json:item><json:item><name>Adriana L. Vieira</name><affiliations><json:string>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</json:string></affiliations></json:item><json:item><name>Sergio P. Rigonatti MD, PhD</name><affiliations><json:string>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</json:string></affiliations></json:item><json:item><name>M. Teresa A. Silva PhD</name><affiliations><json:string>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</json:string></affiliations></json:item><json:item><name>Egberto R. Barbosa MD, PhD</name><affiliations><json:string>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</json:string></affiliations></json:item><json:item><name>Michael A. Nitsche MD</name><affiliations><json:string>Department of Clinical Neurophysiology, Georg August University, Goettingen, Germany</json:string></affiliations></json:item><json:item><name>Alvaro Pascual‐Leone MD, PhD</name><affiliations><json:string>Harvard Center for Non‐Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>transcranial direct current stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>brain DC polarization</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>motor function</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cortical stimulation</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Electrical stimulation of deep brain structures, such as globus pallidus and subthalamic nucleus, is widely accepted as a therapeutic tool for patients with Parkinson's disease (PD). Cortical stimulation either with epidural implanted electrodes or repetitive transcranial magnetic stimulation can be associated with motor function enhancement in PD. We aimed to study the effects of another noninvasive technique of cortical brain stimulation, transcranial direct current stimulation (tDCS), on motor function and motor‐evoked potential (MEP) characteristics of PD patients. We tested tDCS using different electrode montages [anodal stimulation of primary motor cortex (M1), cathodal stimulation of M1, anodal stimulation of dorsolateral prefrontal cortex (DLPFC), and sham‐stimulation] and evaluated the effects on motor function—as indexed by Unified Parkinson's Disease Rating Scale (UPDRS), simple reaction time (sRT) and Purdue Pegboard test—and on corticospinal motor excitability (MEP characteristics). All experiments were performed in a double‐blinded manner. Anodal stimulation of M1 was associated with a significant improvement of motor function compared to sham‐stimulation in the UPDRS (P > 0.001) and sRT (P = 0.019). This effect was not observed for cathodal stimulation of M1 or anodal stimulation of DLPFC. Furthermore, whereas anodal stimulation of M1 significantly increased MEP amplitude and area, cathodal stimulation of M1 significantly decreased them. There was a trend toward a significant correlation between motor function improvement after M1 anodal–tDCS and MEP area increase. These results confirm and extend the notion that cortical brain stimulation might improve motor function in patients with PD. © 2006 Movement Disorder Society</abstract><qualityIndicators><score>7.94</score><pdfVersion>1.3</pdfVersion><pdfPageSize>594 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1765</abstractCharCount><pdfWordCount>6045</pdfWordCount><pdfCharCount>38643</pdfCharCount><pdfPageCount>10</pdfPageCount><abstractWordCount>245</abstractWordCount></qualityIndicators><title>Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease</title><genre><json:string>Serial article</json:string></genre><host><volume>21</volume><pages><total>10</total><last>1702</last><first>1693</first></pages><issn><json:string>0885-3185</json:string></issn><issue>10</issue><subject><json:item><value>Research Article</value></json:item></subject><genre></genre><language><json:string>unknown</json:string></language><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2006</publicationDate><copyrightDate>2006</copyrightDate><doi><json:string>10.1002/mds.21012</json:string></doi><id>8E9F0F54FAEB6C66A66CC89C72020DE06A096B6B</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/8E9F0F54FAEB6C66A66CC89C72020DE06A096B6B/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/8E9F0F54FAEB6C66A66CC89C72020DE06A096B6B/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/8E9F0F54FAEB6C66A66CC89C72020DE06A096B6B/fulltext/tei"><teiHeader type="text"><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>Wiley Subscription Services, Inc., A Wiley Company</p></availability><date>2006</date></publicationStmt><notesStmt><note>Harvard Medical School Scholars in Clinical Science Program - No. NIH K30 HL04095‐03;</note><note>National Institutes of Health - No. K24 RR018875;</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease</title><author><persName><forename type="first">Felipe</forename><surname>Fregni</surname><roleName type="degree">MD, PhD</roleName></persName><note type="correspondence"><p>Correspondence: Harvard Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, KS 452, Boston, MA 02215</p></note><affiliation>Harvard Center for Non‐Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA</affiliation></author><author><persName><forename type="first">Paulo S.</forename><surname>Boggio</surname><roleName type="degree">MSc</roleName></persName><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation><affiliation>Neuroscience Department, Mackenzie University, Sao Paulo, Brazil</affiliation></author><author><persName><forename type="first">Marcelo C.</forename><surname>Santos</surname></persName><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation></author><author><persName><forename type="first">Moises</forename><surname>Lima</surname></persName><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation></author><author><persName><forename type="first">Adriana L.</forename><surname>Vieira</surname></persName><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation></author><author><persName><forename type="first">Sergio P.</forename><surname>Rigonatti</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation></author><author><persName><forename type="first">M. Teresa A.</forename><surname>Silva</surname><roleName type="degree">PhD</roleName></persName><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation></author><author><persName><forename type="first">Egberto R.</forename><surname>Barbosa</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation></author><author><persName><forename type="first">Michael A.</forename><surname>Nitsche</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Clinical Neurophysiology, Georg August University, Goettingen, Germany</affiliation></author><author><persName><forename type="first">Alvaro</forename><surname>Pascual‐Leone</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation>Harvard Center for Non‐Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2006-10"></date><biblScope unit="vol">21</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1693">1693</biblScope><biblScope unit="page" to="1702">1702</biblScope></imprint></monogr><idno type="istex">8E9F0F54FAEB6C66A66CC89C72020DE06A096B6B</idno><idno type="DOI">10.1002/mds.21012</idno><idno type="ArticleID">MDS21012</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2006</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Electrical stimulation of deep brain structures, such as globus pallidus and subthalamic nucleus, is widely accepted as a therapeutic tool for patients with Parkinson's disease (PD). Cortical stimulation either with epidural implanted electrodes or repetitive transcranial magnetic stimulation can be associated with motor function enhancement in PD. We aimed to study the effects of another noninvasive technique of cortical brain stimulation, transcranial direct current stimulation (tDCS), on motor function and motor‐evoked potential (MEP) characteristics of PD patients. We tested tDCS using different electrode montages [anodal stimulation of primary motor cortex (M1), cathodal stimulation of M1, anodal stimulation of dorsolateral prefrontal cortex (DLPFC), and sham‐stimulation] and evaluated the effects on motor function—as indexed by Unified Parkinson's Disease Rating Scale (UPDRS), simple reaction time (sRT) and Purdue Pegboard test—and on corticospinal motor excitability (MEP characteristics). All experiments were performed in a double‐blinded manner. Anodal stimulation of M1 was associated with a significant improvement of motor function compared to sham‐stimulation in the UPDRS (P < 0.001) and sRT (P = 0.019). This effect was not observed for cathodal stimulation of M1 or anodal stimulation of DLPFC. Furthermore, whereas anodal stimulation of M1 significantly increased MEP amplitude and area, cathodal stimulation of M1 significantly decreased them. There was a trend toward a significant correlation between motor function improvement after M1 anodal–tDCS and MEP area increase. These results confirm and extend the notion that cortical brain stimulation might improve motor function in patients with PD. © 2006 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>transcranial direct current stimulation</term></item><item><term>brain DC polarization</term></item><item><term>motor function</term></item><item><term>cortical stimulation</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005-11-29">Received</change><change when="2006-03-13">Registration</change><change when="2006-10">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/8E9F0F54FAEB6C66A66CC89C72020DE06A096B6B/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="100"><doi origin="wiley" registered="yes">10.1002/mds.v21:10</doi><numberingGroup><numbering type="journalVolume" number="21">21</numbering><numbering type="journalIssue">10</numbering></numberingGroup><coverDate startDate="2006-10">October 2006</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="190" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.21012</doi><idGroup><id type="unit" value="MDS21012"></id></idGroup><countGroup><count type="pageTotal" number="10"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2006 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2005-11-29"></event><event type="manuscriptRevised" date="2006-02-24"></event><event type="manuscriptAccepted" date="2006-03-13"></event><event type="publishedOnlineEarlyUnpaginated" date="2006-06-30"></event><event type="firstOnline" date="2006-06-30"></event><event type="publishedOnlineFinalForm" date="2006-10-20"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.18.1 mode:FullText source:FullText result:FullText" date="2010-09-09"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">1693</numbering><numbering type="pageLast">1702</numbering></numberingGroup><correspondenceTo>Harvard Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, KS 452, Boston, MA 02215</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS21012.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="5"></count><count type="tableTotal" number="1"></count><count type="referenceTotal" number="38"></count><count type="wordTotal" number="6724"></count></countGroup><titleGroup><title type="main" xml:lang="en">Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease</title><title type="short" xml:lang="en">Brain DC Stimulation in Parkinson's Disease</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Felipe</givenNames><familyName>Fregni</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email>ffregni@bidmc.harvard.edu</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2 #af3"><personName><givenNames>Paulo S.</givenNames><familyName>Boggio</familyName><degrees>MSc</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Marcelo C.</givenNames><familyName>Santos</familyName></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Moises</givenNames><familyName>Lima</familyName></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Adriana L.</givenNames><familyName>Vieira</familyName></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Sergio P.</givenNames><familyName>Rigonatti</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af2"><personName><givenNames>M. Teresa A.</givenNames><familyName>Silva</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Egberto R.</givenNames><familyName>Barbosa</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Michael A.</givenNames><familyName>Nitsche</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Alvaro</givenNames><familyName>Pascual‐Leone</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Harvard Center for Non‐Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="BR" type="organization"><unparsedAffiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="BR" type="organization"><unparsedAffiliation>Neuroscience Department, Mackenzie University, Sao Paulo, Brazil</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="DE" type="organization"><unparsedAffiliation>Department of Clinical Neurophysiology, Georg August University, Goettingen, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">transcranial direct current stimulation</keyword><keyword xml:id="kwd3">brain DC polarization</keyword><keyword xml:id="kwd4">motor function</keyword><keyword xml:id="kwd5">cortical stimulation</keyword></keywordGroup><fundingInfo><fundingAgency>Harvard Medical School Scholars in Clinical Science Program</fundingAgency><fundingNumber>NIH K30 HL04095‐03</fundingNumber></fundingInfo><fundingInfo><fundingAgency>National Institutes of Health</fundingAgency><fundingNumber>K24 RR018875</fundingNumber></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Electrical stimulation of deep brain structures, such as globus pallidus and subthalamic nucleus, is widely accepted as a therapeutic tool for patients with Parkinson's disease (PD). Cortical stimulation either with epidural implanted electrodes or repetitive transcranial magnetic stimulation can be associated with motor function enhancement in PD. We aimed to study the effects of another noninvasive technique of cortical brain stimulation, transcranial direct current stimulation (tDCS), on motor function and motor‐evoked potential (MEP) characteristics of PD patients. We tested tDCS using different electrode montages [anodal stimulation of primary motor cortex (M1), cathodal stimulation of M1, anodal stimulation of dorsolateral prefrontal cortex (DLPFC), and sham‐stimulation] and evaluated the effects on motor function—as indexed by Unified Parkinson's Disease Rating Scale (UPDRS), simple reaction time (sRT) and Purdue Pegboard test—and on corticospinal motor excitability (MEP characteristics). All experiments were performed in a double‐blinded manner. Anodal stimulation of M1 was associated with a significant improvement of motor function compared to sham‐stimulation in the UPDRS (<i>P</i> < 0.001) and sRT (<i>P</i> = 0.019). This effect was not observed for cathodal stimulation of M1 or anodal stimulation of DLPFC. Furthermore, whereas anodal stimulation of M1 significantly increased MEP amplitude and area, cathodal stimulation of M1 significantly decreased them. There was a trend toward a significant correlation between motor function improvement after M1 anodal–tDCS and MEP area increase. These results confirm and extend the notion that cortical brain stimulation might improve motor function in patients with PD. © 2006 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 4-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Brain DC Stimulation in Parkinson's Disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Felipe</namePart><namePart type="family">Fregni</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Harvard Center for Non‐Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA</affiliation><description>Correspondence: Harvard Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, KS 452, Boston, MA 02215</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Paulo S.</namePart><namePart type="family">Boggio</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation><affiliation>Neuroscience Department, Mackenzie University, Sao Paulo, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marcelo C.</namePart><namePart type="family">Santos</namePart><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Moises</namePart><namePart type="family">Lima</namePart><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Adriana L.</namePart><namePart type="family">Vieira</namePart><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sergio P.</namePart><namePart type="family">Rigonatti</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M. Teresa A.</namePart><namePart type="family">Silva</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Egberto R.</namePart><namePart type="family">Barbosa</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Departments of Experimental Psychology (Institute of Psychology), Psychiatry, and Neurology, University of Sao Paulo, Sao Paulo, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michael A.</namePart><namePart type="family">Nitsche</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Clinical Neurophysiology, Georg August University, Goettingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alvaro</namePart><namePart type="family">Pascual‐Leone</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Harvard Center for Non‐Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2006-10</dateIssued><dateCaptured encoding="w3cdtf">2005-11-29</dateCaptured><dateValid encoding="w3cdtf">2006-03-13</dateValid><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">5</extent><extent unit="tables">1</extent><extent unit="references">38</extent><extent unit="words">6724</extent></physicalDescription><abstract lang="en">Electrical stimulation of deep brain structures, such as globus pallidus and subthalamic nucleus, is widely accepted as a therapeutic tool for patients with Parkinson's disease (PD). Cortical stimulation either with epidural implanted electrodes or repetitive transcranial magnetic stimulation can be associated with motor function enhancement in PD. We aimed to study the effects of another noninvasive technique of cortical brain stimulation, transcranial direct current stimulation (tDCS), on motor function and motor‐evoked potential (MEP) characteristics of PD patients. We tested tDCS using different electrode montages [anodal stimulation of primary motor cortex (M1), cathodal stimulation of M1, anodal stimulation of dorsolateral prefrontal cortex (DLPFC), and sham‐stimulation] and evaluated the effects on motor function—as indexed by Unified Parkinson's Disease Rating Scale (UPDRS), simple reaction time (sRT) and Purdue Pegboard test—and on corticospinal motor excitability (MEP characteristics). All experiments were performed in a double‐blinded manner. Anodal stimulation of M1 was associated with a significant improvement of motor function compared to sham‐stimulation in the UPDRS (P < 0.001) and sRT (P = 0.019). This effect was not observed for cathodal stimulation of M1 or anodal stimulation of DLPFC. Furthermore, whereas anodal stimulation of M1 significantly increased MEP amplitude and area, cathodal stimulation of M1 significantly decreased them. There was a trend toward a significant correlation between motor function improvement after M1 anodal–tDCS and MEP area increase. These results confirm and extend the notion that cortical brain stimulation might improve motor function in patients with PD. © 2006 Movement Disorder Society</abstract><note type="funding">Harvard Medical School Scholars in Clinical Science Program - No. NIH K30 HL04095‐03; </note><note type="funding">National Institutes of Health - No. K24 RR018875; </note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>transcranial direct current stimulation</topic><topic>brain DC polarization</topic><topic>motor function</topic><topic>cortical stimulation</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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