TY - JOUR
T1 - Spinal direct current stimulation (tsDCS) in hereditary spastic paraplegias (HSP)
T2 - A sham-controlled crossover study
AU - Ardolino, Gianluca
AU - Bocci, Tommaso
AU - Nigro, Martina
AU - Vergari, Maurizio
AU - Di Fonzo, Alessio
AU - Bonato, Sara
AU - Cogiamanian, Filippo
AU - Cortese, Francesca
AU - Cova, Ilaria
AU - Barbieri, Sergio
AU - Priori, Alberto
PY - 2021
Y1 - 2021
N2 - Objective: Hereditary spastic paraplegia (HSP) represents a heterogeneous group of neurodegenerative diseases characterized by progressive spasticity and lower limb weakness. We assessed the effects of transcutaneous spinal direct current stimulation (tsDCS) in HSP. Design: A double-blind, randomized, crossover and sham-controlled study. Setting: Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan. Participants: eleven patients with HSP (six men, mean age ± SD: 37.3 ± 8.1 years), eight affected by spastin/SPG4,1 by atlastin1/SPG3a, 1 by paraplegin/SPG7 and 1 by ZFYVE26/SPG15. Interventions: tsDCS (anodal or sham, 2.0 mA, 20’, five days) delivered over the thoracic spinal cord (T10-T12). Outcome measures: Motor-evoked potentials (MEPs), the H-reflex (Hr), F-waves, the Ashworth scale for clinical spasticity, the Five Minutes Walking test and the Spastic Paraplegia Rating Scale (SPRS) were assessed. Patients were evaluated before tsDCS (T0), at the end of the stimulation (T1), after one week (T2), one month (T3) and two months (T4). Results: The score of the Ashworth scale improved in the anodal compared with sham group, up to two months following the end of stimulation (T1, P =.0137; T4, P =.0244), whereas the Five Minutes Walking test and SPRS did not differ between the two groups. Among neurophysiological measures, both anodal and sham tsDCS left Hr, F-waves and MEPs unchanged over time. Conclusions: Anodal tsDCS significantly decreases spasticity and might be a complementary strategy for the treatment of spasticity in HSP.
AB - Objective: Hereditary spastic paraplegia (HSP) represents a heterogeneous group of neurodegenerative diseases characterized by progressive spasticity and lower limb weakness. We assessed the effects of transcutaneous spinal direct current stimulation (tsDCS) in HSP. Design: A double-blind, randomized, crossover and sham-controlled study. Setting: Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan. Participants: eleven patients with HSP (six men, mean age ± SD: 37.3 ± 8.1 years), eight affected by spastin/SPG4,1 by atlastin1/SPG3a, 1 by paraplegin/SPG7 and 1 by ZFYVE26/SPG15. Interventions: tsDCS (anodal or sham, 2.0 mA, 20’, five days) delivered over the thoracic spinal cord (T10-T12). Outcome measures: Motor-evoked potentials (MEPs), the H-reflex (Hr), F-waves, the Ashworth scale for clinical spasticity, the Five Minutes Walking test and the Spastic Paraplegia Rating Scale (SPRS) were assessed. Patients were evaluated before tsDCS (T0), at the end of the stimulation (T1), after one week (T2), one month (T3) and two months (T4). Results: The score of the Ashworth scale improved in the anodal compared with sham group, up to two months following the end of stimulation (T1, P =.0137; T4, P =.0244), whereas the Five Minutes Walking test and SPRS did not differ between the two groups. Among neurophysiological measures, both anodal and sham tsDCS left Hr, F-waves and MEPs unchanged over time. Conclusions: Anodal tsDCS significantly decreases spasticity and might be a complementary strategy for the treatment of spasticity in HSP.
KW - Hereditary spastic paraplegias
KW - Movement disorders
KW - Non-invasive spinal stimulation
KW - Spasticity treatment
KW - Transcutaneous spinal direct current stimulation
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U2 - 10.1080/10790268.2018.1543926
DO - 10.1080/10790268.2018.1543926
M3 - Article
AN - SCOPUS:85058084725
VL - 44
SP - 46
EP - 53
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
SN - 1079-0268
IS - 1
ER -