Spinal direct current stimulation (tsDCS) in hereditary spastic paraplegias (HSP): A sham-controlled crossover study

Gianluca Ardolino, Tommaso Bocci, Martina Nigro, Maurizio Vergari, Alessio Di Fonzo, Sara Bonato, Filippo Cogiamanian, Francesca Cortese, Ilaria Cova, Sergio Barbieri, Alberto Priori

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4 Citations (Scopus)

Abstract

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.

Original languageEnglish
JournalJournal of Spinal Cord Medicine
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Hereditary Spastic Paraplegia
Cross-Over Studies
H-Reflex
Motor Evoked Potentials
Paraplegia
Walking
Neurodegenerative Diseases
Lower Extremity
Spinal Cord
Thorax
Outcome Assessment (Health Care)

Keywords

  • Hereditary spastic paraplegias
  • Movement disorders
  • Non-invasive spinal stimulation
  • Spasticity treatment
  • Transcutaneous spinal direct current stimulation

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

@article{be03d0a82e78484dbce7b596a89a51c0,
title = "Spinal direct current stimulation (tsDCS) in hereditary spastic paraplegias (HSP): A sham-controlled crossover study",
abstract = "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 C{\`a} 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.",
keywords = "Hereditary spastic paraplegias, Movement disorders, Non-invasive spinal stimulation, Spasticity treatment, Transcutaneous spinal direct current stimulation",
author = "Gianluca Ardolino and Tommaso Bocci and Martina Nigro and Maurizio Vergari and {Di Fonzo}, Alessio and Sara Bonato and Filippo Cogiamanian and Francesca Cortese and Ilaria Cova and Sergio Barbieri and Alberto Priori",
year = "2018",
month = "1",
day = "1",
doi = "10.1080/10790268.2018.1543926",
language = "English",
journal = "Journal of Spinal Cord Medicine",
issn = "1079-0268",
publisher = "Maney Publishing",

}

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 - 2018/1/1

Y1 - 2018/1/1

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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