Multiday Transcranial Direct Current Stimulation Causes Clinically Insignificant Changes in Childhood Dystonia: A Pilot Study

J Child Neurol. 2015 Oct;30(12):1604-15. doi: 10.1177/0883073815575369. Epub 2015 Mar 19.

Abstract

Abnormal motor cortex activity is common in dystonia. Cathodal transcranial direct current stimulation may alter cortical activity by decreasing excitability while anodal stimulation may increase motor learning. Previous results showed that a single session of cathodal transcranial direct current stimulation can improve symptoms in childhood dystonia. Here we performed a 5-day, sham-controlled, double-blind, crossover study, where we measured tracking and muscle overflow in a myocontrol-based task. We applied cathodal and anodal transcranial direct current stimulation (2 mA, 9 minutes per day). For cathodal transcranial direct current stimulation (7 participants), 3 subjects showed improvements whereas 2 showed worsening in overflow or tracking error. The effect size was small (about 1% of maximum voluntary contraction) and not clinically meaningful. For anodal transcranial direct current stimulation (6 participants), none showed improvement, whereas 5 showed worsening. Thus, multiday cathodal transcranial direct current stimulation reduced symptoms in some children but not to a clinically meaningful extent, whereas anodal transcranial direct current stimulation worsened symptoms. Our results do not support transcranial direct current stimulation as clinically viable for treating childhood dystonia.

Keywords: cerebral palsy; dystonia; electromyogram; overflow; transcranial direct current stimulation.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cerebral Palsy / physiopathology
  • Cerebral Palsy / therapy
  • Child
  • Cross-Over Studies
  • Double-Blind Method
  • Dystonic Disorders / physiopathology*
  • Dystonic Disorders / therapy*
  • Electromyography
  • Female
  • Hand / physiopathology
  • Humans
  • Male
  • Motor Activity / physiology
  • Motor Cortex / physiopathology*
  • Muscle, Skeletal / physiopathology
  • Pilot Projects
  • Transcranial Direct Current Stimulation / methods*
  • Treatment Outcome
  • Young Adult