Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot Study
Objective: Cerebrovascular accidents are the second leading cause of death and the third leading cause of disability worldwide. We hypothesized that cerebellar transcranial direct current stimulation (ctDCS) of the dentate nuclei and the lower-limb representations in the cerebellum can improve funct...
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doaj-22b09cf3c0fb4982a47566bb71c069282020-11-25T01:14:52ZengMDPI AGBrain Sciences2076-34252020-02-011029410.3390/brainsci10020094brainsci10020094Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot StudyZeynab Rezaee0Surbhi Kaura1Dhaval Solanki2Adyasha Dash3M V Padma Srivastava4Uttama Lahiri5Anirban Dutta6Department of Biomedical Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USAAll India Institute of Medical Sciences, New Delhi 110029, IndiaIndian Institute of Technology Gandhinagar, Palaj 382355, IndiaIndian Institute of Technology Gandhinagar, Palaj 382355, IndiaAll India Institute of Medical Sciences, New Delhi 110029, IndiaIndian Institute of Technology Gandhinagar, Palaj 382355, IndiaDepartment of Biomedical Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USAObjective: Cerebrovascular accidents are the second leading cause of death and the third leading cause of disability worldwide. We hypothesized that cerebellar transcranial direct current stimulation (ctDCS) of the dentate nuclei and the lower-limb representations in the cerebellum can improve functional reach during standing balance in chronic (>6 months’ post-stroke) stroke survivors. Materials and Methods: Magnetic resonance imaging (MRI) based subject-specific electric field was computed across a convenience sample of 10 male chronic (>6 months) stroke survivors and one healthy MRI template to find an optimal bipolar bilateral ctDCS montage to target dentate nuclei and lower-limb representations (lobules VII−IX). Then, in a repeated-measure crossover study on a subset of 5 stroke survivors, we compared 15 min of 2 mA ctDCS based on the effects on successful functional reach (%) during standing balance task. Three-way ANOVA investigated the factors of interest− brain regions, montages, stroke participants, and their interactions. Results: “One-size-fits-all” bipolar ctDCS montage for the clinical study was found to be PO9h−PO10h for dentate nuclei and Exx7−Exx8 for lobules VII−IX with the contralesional anode. PO9h−PO10h ctDCS performed significantly (alpha = 0.05) better in facilitating successful functional reach (%) when compared to Exx7−Exx8 ctDCS. Furthermore, a linear relationship between successful functional reach (%) and electric field strength was found where PO9h−PO10h montage resulted in a significantly (alpha = 0.05) higher electric field strength when compared to Exx7−Exx8 montage for the same 2 mA current. Conclusion: We presented a rational neuroimaging based approach to optimize deep ctDCS of the dentate nuclei and lower limb representations in the cerebellum for post-stroke balance rehabilitation. However, this promising pilot study was limited by “one-size-fits-all” bipolar ctDCS montage as well as a small sample size.https://www.mdpi.com/2076-3425/10/2/94cerebellar transcranial direct current stimulationdentate nucleuscomputational modeling |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zeynab Rezaee Surbhi Kaura Dhaval Solanki Adyasha Dash M V Padma Srivastava Uttama Lahiri Anirban Dutta |
spellingShingle |
Zeynab Rezaee Surbhi Kaura Dhaval Solanki Adyasha Dash M V Padma Srivastava Uttama Lahiri Anirban Dutta Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot Study Brain Sciences cerebellar transcranial direct current stimulation dentate nucleus computational modeling |
author_facet |
Zeynab Rezaee Surbhi Kaura Dhaval Solanki Adyasha Dash M V Padma Srivastava Uttama Lahiri Anirban Dutta |
author_sort |
Zeynab Rezaee |
title |
Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot Study |
title_short |
Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot Study |
title_full |
Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot Study |
title_fullStr |
Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot Study |
title_full_unstemmed |
Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot Study |
title_sort |
deep cerebellar transcranial direct current stimulation of the dentate nucleus to facilitate standing balance in chronic stroke survivors—a pilot study |
publisher |
MDPI AG |
series |
Brain Sciences |
issn |
2076-3425 |
publishDate |
2020-02-01 |
description |
Objective: Cerebrovascular accidents are the second leading cause of death and the third leading cause of disability worldwide. We hypothesized that cerebellar transcranial direct current stimulation (ctDCS) of the dentate nuclei and the lower-limb representations in the cerebellum can improve functional reach during standing balance in chronic (>6 months’ post-stroke) stroke survivors. Materials and Methods: Magnetic resonance imaging (MRI) based subject-specific electric field was computed across a convenience sample of 10 male chronic (>6 months) stroke survivors and one healthy MRI template to find an optimal bipolar bilateral ctDCS montage to target dentate nuclei and lower-limb representations (lobules VII−IX). Then, in a repeated-measure crossover study on a subset of 5 stroke survivors, we compared 15 min of 2 mA ctDCS based on the effects on successful functional reach (%) during standing balance task. Three-way ANOVA investigated the factors of interest− brain regions, montages, stroke participants, and their interactions. Results: “One-size-fits-all” bipolar ctDCS montage for the clinical study was found to be PO9h−PO10h for dentate nuclei and Exx7−Exx8 for lobules VII−IX with the contralesional anode. PO9h−PO10h ctDCS performed significantly (alpha = 0.05) better in facilitating successful functional reach (%) when compared to Exx7−Exx8 ctDCS. Furthermore, a linear relationship between successful functional reach (%) and electric field strength was found where PO9h−PO10h montage resulted in a significantly (alpha = 0.05) higher electric field strength when compared to Exx7−Exx8 montage for the same 2 mA current. Conclusion: We presented a rational neuroimaging based approach to optimize deep ctDCS of the dentate nuclei and lower limb representations in the cerebellum for post-stroke balance rehabilitation. However, this promising pilot study was limited by “one-size-fits-all” bipolar ctDCS montage as well as a small sample size. |
topic |
cerebellar transcranial direct current stimulation dentate nucleus computational modeling |
url |
https://www.mdpi.com/2076-3425/10/2/94 |
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