Safety and feasibility of transcranial direct current stimulation in amyotrophic lateral sclerosis - a pilot study with a single subject experimental design

Physiother Theory Pract. 2019 May;35(5):458-463. doi: 10.1080/09593985.2018.1443536. Epub 2018 Feb 28.

Abstract

Introduction: Transcranial direct current stimulation (tDCS) has been explored as a neuromodulatory tool to prime motor function in several neurological disorders. Studies using tDCS in amyotrophic lateral sclerosis (ALS) are limited. We investigated the safety, feasibility and effects of long-term tDCS in an individual with ALS.

Methods: A 36-year-old male diagnosed with clinically definite ALS received 12 sessions each of anodal, sham, and cathodal tDCS. Outcome measures included disease progression (revised ALS functional rating scale (ALSFRS-R)), clinical measures of endurance and mobility, and corticomotor excitability.

Results: No adverse events or change in disease progression were noticed during the study. Small improvement in gait speed (15% increase) was noticed with anodal tDCS only.

Conclusions: This case study demonstrates the safety and feasibility of long-term facilitatory and inhibitory tDCS on a single participant with ALS. This study serves as a guideline for implementing tDCS in future ALS trials.

Keywords: Amyotrophic lateral sclerosis; cortical excitability; neurodegenerative disease; transcranial direct current stimulation; transcranial magnetic stimulation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amyotrophic Lateral Sclerosis / pathology
  • Amyotrophic Lateral Sclerosis / physiopathology
  • Amyotrophic Lateral Sclerosis / therapy*
  • Gait
  • Gait Analysis
  • Humans
  • Male
  • Motor Activity*
  • Motor Cortex / physiopathology*
  • Motor Neurons / pathology*
  • Muscle, Skeletal / innervation*
  • Nerve Degeneration
  • Recovery of Function
  • Time Factors
  • Transcranial Direct Current Stimulation*
  • Treatment Outcome
  • Walk Test