tDCS for Cognitive Impairment in Parkinson's Disease
(tDCS-PD-fMRI Trial)
Trial Summary
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications. However, if you are taking tricyclic antidepressants, neuroleptic medications, or other drugs that lower seizure threshold, you may not be eligible to participate.
What data supports the effectiveness of the treatment High-definition transcranial direct current stimulation (tDCS) for cognitive impairment in Parkinson's Disease?
Research shows that tDCS can improve certain cognitive functions in Parkinson's patients, like executive functions, which involve planning and decision-making. However, the effects on other cognitive areas like memory and attention are less clear, and more research is needed to confirm long-term benefits.12345
Is transcranial direct current stimulation (tDCS) safe for humans?
Research shows that tDCS is generally safe for humans, with no reports of serious or lasting side effects when used at standard levels (up to 4 milliamperes for 40 minutes). This includes studies involving over 33,200 sessions and 1,000 subjects, even among potentially vulnerable groups like the elderly and those with mood disorders.36789
How does high-definition transcranial direct current stimulation (tDCS) differ from other treatments for cognitive impairment in Parkinson's disease?
High-definition transcranial direct current stimulation (tDCS) is unique because it is a non-invasive brain stimulation technique that modulates brain activity to improve cognitive and motor functions in Parkinson's disease, unlike traditional drug therapies that primarily target symptoms through medication. It involves applying a mild electrical current to specific brain areas, which can enhance cognitive abilities and reduce movement-related symptoms without the side effects associated with medications.12345
What is the purpose of this trial?
Parkinson's disease (PD) has been classically regarded as a "movement disorder", so earlier work has focused on treating motor symptoms only. As PD patients now have longer life expectancy, the relatively slowly progressing cognitive deficits (compared to their motor deficits) have become one of the major challenges. Approximately 80% of PD patients eventually become demented. Therefore cognitive dysfunction is one of the most significant factors affecting the quality of life of patients with PD. While dementia in Parkinson's disease is routinely treated by cholinesterase inhibitors (e.g., donepezil and rivastigmine), their efficacy on mild cognitive impairment found in non-demented PD is questionable. Alternative approaches have been proposed including transcranial direct current stimulation (tDCS) but no consensus has been reached. This can be attributed mainly to: (1) imprecise knowledge of the underlying functional circuitry mediating this disease manifestation and (2) inter-individual variability. Here, the investigators will utilize a novel personalized network analysis approach to elucidate on the underlying mechanisms of the effect of tDCS on cognitive dysfunction in non-demented PD patients.It has been well documented that the caudate nucleus plays an important role in cognitive dysfunction found in PD. In the investigators' preliminary resting-state functional magnetic resonance imaging (fMRI) study, they have shown that the connectivity of the right caudate nucleus is correlated to cognitive status of PD patients measured by the Montreal Cognitive Assessment (MoCA). The investigators hypothesize that tDCS on the left and/or right dorsolateral prefrontal cortex may restore the functional connectivity of the right caudate nucleus which may in turn improve patients' cognitive performance.
Eligibility Criteria
This trial is for English-speaking adults over 40 with Parkinson's Disease who can consent and have at least two classic symptoms without other known causes. They should not be demented, as determined by a specific cognitive test, and must not have severe movement issues that could affect scans.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive transcranial direct current stimulation (tDCS) on the left and/or right dorsolateral prefrontal cortex to improve cognitive performance
Follow-up
Participants are monitored for safety and effectiveness after treatment
Treatment Details
Interventions
- High-definition transcranial direct current stimulation
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of Manitoba
Lead Sponsor
Parkinson Society Canada
Collaborator