Treatments for Neurological Gait and Balance Disturbance: The Use of Noninvasive Electrical Brain Stimulation

摘要

Neurological gait disorders are a common cause of falls, morbidity, and mortality, particularly amongst the elderly. Neurological gait and balance impairment has, however, proved notoriously difficult to treat. The following review discusses some of the first experiments to modulate gait and balance in healthy adults using anodal transcranial direct current stimulation (tDCS) by stimulating both cerebral hemispheres simultaneously. We review and discuss published data using this novel tDCS approach, in combination with physical therapy, to treat locomotor and balance disorders in patients with small vessel disease (leukoaraiosis) and Parkinson’s disease. Finally, we review the use of bihemispheric anodal tDCS to treat gait impairment in patients with stroke in the subacute phase. The findings of these studies suggest that noninvasive electrical stimulation techniques may be a useful adjunct to physical therapy in patients with neurological gait disorders, but further mutlicentre randomized sham-controlled studies are needed to evaluate whether experimental tDCS use can translate into mainstream clinical practice for the treatment of neurological gait disorders.