Priming of postural training with cerebellar anodal transcranial direct current stimulation for its effects on postural balance and fear of falling in patients with multiple sclerosis: A randomized, double-blind, sham-controlled study

Fatemeh Ehsani; Morteza Ahmadi; Nooshin Masoudian; Shapour Jaberzadeh

doi:10.1016/j.jocn.2022.03.025

Priming of postural training with cerebellar anodal transcranial direct current stimulation for its effects on postural balance and fear of falling in patients with multiple sclerosis: A randomized, double-blind, sham-controlled study

J Clin Neurosci. 2022 May:99:294-301. doi: 10.1016/j.jocn.2022.03.025. Epub 2022 Mar 21.

Authors

Fatemeh Ehsani¹, Morteza Ahmadi², Nooshin Masoudian³, Shapour Jaberzadeh⁴

Affiliations

¹ Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: f.ehsani@semums.ac.ir.
² Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran.
³ Specialist in Neurology, Neurology Ward, Department of Internal Medicine, Kosar Hospital, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
⁴ Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.

PMID: 35325728
DOI: 10.1016/j.jocn.2022.03.025

Abstract

Postural impairment is one of the most disorders in patients with multiple sclerosis (MS), while fear of falling can exacerbate it in these patients. One of the leading causes of postural impairment and fear of falling in patients with MS is the cerebellum region's abnormalities, which may be modulated by cerebellar anodal transcranial direct current stimulation (a-tDCS). The present study aimed to investigate the effects of cerebellar a-tDCS concurrent with postural training (cerebellar a-CS_C-PT) on postureand fear of falling in patients with MS. Thirty-seven patients with MS were assessed to randomly assign into cerebellar a-tDCS_C-PT, shamtDCS_C-PT, and postural training alone groups. All groups received 10-session postural training, while 20-minute cerebellar a-tDCS was added in the tDCS groups. Before, immediately and one month after the intervention, posture, balance and fear of falling were assessed using Biodex Balance System, Berg Balance Scale (BBS), and Fall Efficacy Scale-International (FES-I), respectively. Postural stability indices, BBS, and FES-I scores improved immediately and one month after the intervention in the cerebellar a-tDCS_C-PT group (p < 0.001). Postural stability indices were immediately improved after intervention in the control groups (P < 0.05), while the changes were not maintained one month after intervention (P > 0.05). However, FES-I was not changed after the intervention in the control groups (P > 0.05). Cerebellar a-tDCS induces the effects of postural training on posture and balance and controls the fear of falling. This knowledge helps the physicians/therapists plan tDCS interventions to improve the balance, posture, and fear of falling in MS patients.

Keywords: Anodal transcranial direct current stimulation; Cerebellum; Fear of falling; Multiple sclerosis; Postural training; Posture.

Publication types

Randomized Controlled Trial

MeSH terms

Cerebellum / physiology
Double-Blind Method
Fear
Humans
Multiple Sclerosis* / therapy
Postural Balance / physiology
Transcranial Direct Current Stimulation*