Neurologic music therapy combined with EEG-tDCS for upper motor extremity performance in patients with corticobasal syndrome: Study protocol for a novel approach

Kyurim Kang; Jan Stenum; Ryan T Roemmich; Nathan H Heller; Christophe Jouny; Alexander Pantelyat

doi:10.1016/j.cct.2022.107058

Neurologic music therapy combined with EEG-tDCS for upper motor extremity performance in patients with corticobasal syndrome: Study protocol for a novel approach

Contemp Clin Trials. 2023 Feb:125:107058. doi: 10.1016/j.cct.2022.107058. Epub 2022 Dec 19.

Authors

Kyurim Kang¹, Jan Stenum², Ryan T Roemmich², Nathan H Heller³, Christophe Jouny⁴, Alexander Pantelyat⁵

Affiliations

¹ School of Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America; Center for Music and Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America.
² Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States of America; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
³ Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States of America.
⁴ School of Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America.
⁵ School of Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America; Center for Music and Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America. Electronic address: apantel1@jhmi.edu.

PMID: 36549380
DOI: 10.1016/j.cct.2022.107058

Abstract

Background: Corticobasal syndrome (CBS) is an atypical parkinsonian disorder that involves degeneration of brain regions associated with motor coordination and sensory processing. Combining transcranial direct current stimulation (tDCS) with rehabilitation training has been shown to improve upper-limb performance in other disease models. Here, we describe the protocol investigating whether tDCS with neurologic music therapy (NMT) (patterned sensory enhancement and therapeutic instrumental music performance) enhances functional arm/hand performance in individuals with CBS.

Methods: Study participants are randomly assigned to six 30-min sessions (twice per week for 3 weeks) of NMT + either sham tDCS or active tDCS. We aim to stimulate the frontoparietal cortex, which is associated with movement execution/coordination and sensory processing. The hemisphere contralateral to the more affected arm is stimulated (total stimulation current of 2 mA from 5 dime-sized electrodes). Individualized NMT sessions designed to exercise the upper limb are provided. Participants undergo gross/fine motor, cognitive and emotional assessments at baseline and follow-up (one month after the final session). To investigate the immediate effects of tDCS and NMT training, gross /fine motor, affective level, and kinematic parameter measurements using motion sensors are collected before and after each session. Electroencephalography is used to collect electrical neurophysiological responses before, during, and after tDCS+NMT sessions. The study participants, neurologic music therapist and outcome assessor are blinded to whether participants are in the sham or active tDCS group.

Conclusion: This noninvasive and patient-centered clinical trial for CBS may provide insight into rehabilitation options that are sorely lacking in this population.

Keywords: Corticobasal syndrome; Electroencephalography (EEG); Neurologic music therapy (NMT); Transcranial direct current stimulation (tDCS); Upper limb function.

Publication types

Clinical Trial Protocol

MeSH terms

Corticobasal Degeneration* / rehabilitation
Double-Blind Method
Electroencephalography
Humans
Music Therapy*
Randomized Controlled Trials as Topic
Transcranial Direct Current Stimulation / methods
Upper Extremity