Medical Journal of Mashhad university of Medical Sciences

Medical Journal of Mashhad university of Medical Sciences

The Effect of transcranial direct current stimulation with balance training on static and dynamic postural control in MS patients

Document Type : Research Paper

Authors
Hamidreza Taheri 1
Elahe Teymuri 2
Alireza Saberi kakhki 3
1 Professor of Motor Behavior, Ferdowsi University of Mashhad, Mashhad, Iran
2 Master of Motor Behavior, Ferdowsi University of Mashhad, Mashhad, Iran
3 Associate Professor of Motor Behavior, Ferdowsi University of Mashhad, Mashhad, Iran
10.22038/mjms.2020.17165
Abstract
Introduction: Multiple sclerosis (MS) is a chronic disease of the central nervous system in which the myelin of the central nervous system is damaged. One of the areas that are affected in MS is the cerebellum. Disorders in this structure lead to ataxia, imbalance. Recent studies have shown Transcranial direct current stimulation (tDCS) is the application of weak electrical currents (1-2 mA) to modulate the activity of neurons in the brain. However, the main aim of this study was to investigate the effect of cerebellar transcranial direct current stimulation (ctDCS) on postural control in woman with MS.
Methods: The study samples were 20 women with MS (30 to 40 years).Patients received sham or real anodal tDCS of cerebellar for 5 consecutive days in a randomized, sham-controlled study. Main Outcome Measures: postural control (Berg Balance Scale (BBS) and Time up and Go (TUG)), were evaluated. The Neuropsychological evaluation was conducted at baseline and immediately after the ctDCS and one month after the completion of the intervention.
Results: Repeated-measures ANOVA was used for the intragroup analyses and intergroup analyses. Berg Balance Scale and Time up and Go scores improved in after active anodal tDCS only were improved in intervention group.
Conclusion: These preliminary data support the notion that tDCS of the cerebellar combined with balance training improves postural control in women with MS. However Future work has to evaluate potential benefits of cerebellar tDCS on postural control in People with MS.

Keywords
tDCS
postural control
cerebellum
Balance Training
Multiple Sclerosis
  1. Messner B, Bernhard D. Smoking and cardiovascular disease: mechanisms of endothelial
    dysfunction and early atherogenesis. Arteriosclerosis, thrombosis, and vascular biology. 2014
    Mar;34(3):509-15.
    2. Burns DM. Epidemiology of smoking-induced cardiovascular disease. Progress in cardiovascular diseases.
    2003 Jul 1;46(1):11-29.
    3. Cooper KH, Gey GO, Bottenberg RA. Effects of cigarette smoking on endurance performance. Jama.
    1968 Jan 15;203(3):189-92.
    4. Marti B, Theodor A, Minder CE, Vader JP. Smoking, alcohol consumption, and endurance
    capacity: an analysis of 6,500 19-year-old conscripts and 4,100 joggers. Preventive medicine. 1988
    Jan 1;17(1):79-92.
    5. Sandvik L, Erikssen J, Ellestad M, Erikssen G, Thaulow E, Mundal R, Rodahl K. Heart rate
    increase and maximal heart rate during exercise as predictors of cardiovascular mortality: a 16-year
    follow-up study of 1960 healthy men. Coronary artery disease. 1995 Aug 1;6(8):667-79.
    6. Hawari FI, Obeidat NA, Ayub H, Ghonimat I, Eissenberg T, Dawahrah S, Beano H. The acute effects of
    waterpipe smoking on lung function and exercise capacity in a pilot study of healthy participants. Inhalation
    toxicology. 2013 Aug 1;25(9):492-7.
  2. 7. Talukder MAH, Johnson WM, Varadharaj S, Lian J, Kearns PN, El-Mahdy MA, et al. Chronic cigarette smoking
    causes hypertension, increased oxidative stress, impaired NO bioavailability, endothelial dysfunction, and cardiac
    remodeling in mice. Am J Physiol Hear Circ Physiol. 2011 Jan;300(1):H388-96.
    8. Dyer AR, Persky V, Stamler J, Paul O, Shekelle RB, Berkson DM, Lepper M, Schoenberger JA, Lindberg
    HA. Heart rate as a prognostic factor for coronary heart disease and mortality: findings in three Chicago
    epidemiologic studies. American journal of epidemiology. 1980 Dec 1;112(6):736-49.
    9. Kannel WB, Kannel C, Paffenbarger Jr RS, Cupples LA. Heart rate and cardiovascular mortality: the
    Framingham Study. American heart journal. 1987 Jun 1;113(6):1489-94.
    10. Shaper AG, Wannamethee G, Macfarlane PW, Walker M. Heart rate, ischaemic heart disease, and
    sudden cardiac death in middle-aged British men. Heart. 1993 Jul 1;70(1):49-55.
    11. Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetière P. Heart-rate profile during
    exercise as a predictor of sudden death. New England journal of medicine. 2005 May 12;352(19):1951-8.
    12. Gillum RF. Epidemiology of resting pulse rate of persons ages 25-74--data from NHANES 1971-74. Public Health
    Rep. 1992 Mar-Apr; 107(2):193–201.
    13. Cryer PE, Haymond MW, Santiago JV, Shah SD. Norepinephrine and epinephrine release and adrenergic
    mediation of smoking-associated hemodynamic and metabolic events. New England journal of medicine.
    1976 Sep 9;295(11):573-7.
    14. Savonen KP, Lakka TA, Laukkanen JA, Halonen PM, Rauramaa TH, Salonen JT, et al. Heart rate response during
    exercise test and cardiovascular mortality in middle-aged men. Eur Heart J. 2006 Mar;27(5):582–8.
    15. Myers J, Tan SY, Abella J, Aleti V, Froelicher VF. Comparison of the chronotropic response to exercise
    and heart rate recovery in predicting cardiovascular mortality. European Journal of Preventive Cardiology.
    2007 Apr 1;14(2):215-21.
    16. Palatini P. Heart rate as an independent risk factor for cardiovascular disease. Drugs. 2007 Dec;67(2):3-
    13.
    17. Perret-Guillaume C, Joly L, Benetos A. Heart rate as a risk factor for cardiovascular disease.
    Progress in cardiovascular diseases. 2009 Jul 1;52(1):6-10.
    18. Lauer MS. Chronotropic incompetence: ready for prime time.
    19. Morise AP. Heart rate recovery: predictor of risk today and target of therapy tomorrow?.
    20. Kohl 3rd HW, Nichaman MZ, Frankowski RF, Blair SN. Maximal exercise hemodynamics and risk of
    mortality in apparently healthy men and women. Medicine and science in sports and exercise. 1996 May
    1;28(5):601-9.
    21. Bruce RA, DeRouen TA, Hossack KF, Blake B, Hofer VR. Value of maximal exercise tests in risk
    assessment of primary coronary heart disease events in healthy men: five years' experience of the Seattle
    Heart Watch Study. The American journal of cardiology. 1980 Sep 1;46(3):371-8.
    22. Lauer MS, Pashkow FJ, Larson MG, Levy D. Association of cigarette smoking with chronotropic
    incompetence and prognosis in the Framingham Heart Study. Circulation. 1997 Aug 5;96(3):897-903.
    23. Srivastava R, Blackstone EH, Lauer MS. Association of smoking with abnormal exercise heart rate
    responses and long-term prognosis in a healthy, population-based cohort. The American journal of medicine.
    2000 Jul 28;109(1):20-6.
    24. Cole CR, Foody JM, Blackstone EH, Lauer MS. Heart rate recovery after submaximal exercise testing as
    a predictor of mortality in a cardiovascularly healthy cohort. Annals of internal medicine. 2000 Apr
    4;132(7):552-5.
    25. Morshedi-Meibodi A, Larson MG, Levy D, O’Donnell CJ, Vasan RS. Heart rate recovery after treadmill
    exercise testing and risk of cardiovascular disease events (The Framingham Heart Study). The American
    journal of cardiology. 2002 Oct 15;90(8):848-52.
    26. Antelmi I, De Paula RS, Shinzato AR, Peres CA, Mansur AJ, Grupi CJ. Influence of age, gender, body
    mass index, and functional capacity on heart rate variability in a cohort of subjects without heart disease. The
    American journal of cardiology. 2004 Feb 1;93(3):381-5.
    27. Koenig J, Jarczok MN, Warth M, Ellis RJ, Bach C, Hillecke TK, Thayer JF. Body mass index is related
    to autonomic nervous system activity as measured by heart rate variability—a replication using short term
    measurements. The journal of nutrition, health & aging. 2014 Mar;18(3):300-2.
    28. Felber Dietrich D, Ackermann-Liebrich U, Schindler C, Barthélémy JC, Brändli O, Gold DR, Knöpfli B,
    Probst-Hensch NM, Roche FD, Tschopp JM, von Eckardstein A. Effect of physical activity on heart rate
    variability in normal weight, overweight and obese subjects: results from the SAPALDIA study. European journal of applied physiology. 2008;104(3):557-65.
    29. Ohira T, Tanigawa T, Tabata M, Imano H, Kitamura A, Kiyama M, Sato S, Okamura T, Cui R, Koike
    KA, Shimamoto T. Effects of habitual alcohol intake on ambulatory blood pressure, heart rate, and its
    variability among Japanese men. Hypertension. 2009 Jan 1;53(1):13-9.
    30. Papathanasiou G, Georgakopoulos D, Papageorgiou E, Zerva E, Michalis L, Kalfakakou V, et al. Effects of
    smoking on heart rate at rest and during exercise, and on heart rate recovery, in young adults. Int J Environ Res Public
    Health. 2019 Mar 21;16(6):1032.
    31. Papathanasiou G, Georgakopoulos D, Georgoudis G, Spyropoulos P, Perrea D, Evangelou A. Effects of
    chronic smoking on exercise tolerance and on heart rate-systolic blood pressure product in young healthy
    adults. European Journal of Preventive Cardiology. 2007 Oct 1;14(5):646-52.
    32. Laustiola KE, Lassila R, Kaprio J, Koskenvuo M. Decreased beta-adrenergic receptor density and
    catecholamine response in male cigarette smokers. A study of monozygotic twin pairs discordant for
    smoking. Circulation. 1988 Nov;78(5):1234-40.
    33. Perret-Guillaume C, Joly L, Benetos A. Heart rate as a risk factor for cardiovascular disease. Progress in
    cardiovascular diseases. 2009 Jul 1;52(1):6-10.
    34. Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, et al. Exercise Standards for Testing and
    Training. A Scientific Statement From the American Heart Association. Circulation. 2013; 128:873-934
    35. Gidding SS, Xie X, Liu K, Manolio T, Flack JM, Gardin JM. Cardiac function in smokers and
    nonsmokers: the CARDIA study. Journal of the American College of Cardiology. 1995 Jul;26(1):211-6.
    36. Al-Safi SA. Does smoking affect blood pressure and heart rate?. European Journal of Cardiovascular
    Nursing. 2005 Dec 1;4(4):286-9.
    37. Kobayashi Y, Takeuchi T, Hosoi T, Loeppky JA. Effects of habitual smoking on cardiorespiratory
    responses to sub-maximal exercise. Journal of physiological anthropology and applied human science.
    2004;23(5):163-9.
    38. Kumar P, Balakrishnan R, Rao CA. Effects of smoking on heart rate at rest and during submaximal
    exercise, heart rate recovery and blood pressure in young adults.
    39. Benowitz NL. Cigarette smoking and cardiovascular disease: pathophysiology and implications for
    treatment. Progress in cardiovascular diseases. 2003 Jul 1;46(1):91-111.
    40. Lucini D, Bertocchi F, Malliani A, Pagani M. A controlled study of the autonomic changes produced by
    habitual cigarette smoking in healthy subjects. Cardiovascular research. 1996 Apr 1;31(4):633-9.
    41. Hayano J, Yamada M, Sakakibara Y, Fujinami T, Yokoyama K, Watanabe Y, Takata K. Short-and longterm effects of cigarette smoking on heart rate variability. The American journal of cardiology. 1990 Jan
    1;65(1):84-8.
    42. Laustiola KE, Lassila R, Kaprio J, Koskenvuo M. Decreased beta-adrenergic receptor density
    and catecholamine response in male cigarette smokers. A study of monozygotic twin pairs
    discordant for smoking. Circulation. 1988 Nov;78(5):1234-40.
    43. Narkiewicz K, Van De Borne PJ, Hausberg M, Cooley RL, Winniford MD, Davison DE, Somers VK.
    Cigarette smoking increases sympathetic outflow in humans. Circulation. 1998 Aug 11;98(6):528-34.
    44. Hering D, Somers VK, Kara T, Kucharska W, Jurak P, Bieniaszewski L, Narkiewicz K. Sympathetic
    neural responses to smoking are age dependent. Journal of hypertension. 2006 Apr 1;24(4):691-5.
    45. Shalnova S, Shestov DB, Ekelund LG, Abernathy JR, Plavinskaya S, Thomas RP, Williams DH, Deev
    A, Davis CE. Blood pressure and heart rate response during exercise in men and women in the USA and
    Russia lipid research clinics prevalence study. Atherosclerosis. 1996 Apr 26;122(1):47-57.
    46. Savonen KP, Lakka TA, Laukkanen JA, Rauramaa TH, Salonen JT, Rauramaa R. Effectiveness of
    workload at the heart rate of 100 beats/min in predicting cardiovascular mortality in men aged 42, 48, 54, or
    60 years at baseline. The American journal of cardiology. 2007 Aug 15;100(4):563-8.
    47. Sidney S, Sternfeld BA, Gidding SS, Jacobs Jr DR, Bild DE, Oberman A, Haskell WL, Crow RS, Gardin
    JM. Cigarette smoking and submaximal exercise test duration in a biracial population of young adults: the
    CARDIA study. Medicine and science in sports and exercise. 1993 Aug 1;25(8):911-6.
    48. Bernaards CM, Twisk JW, Van Mechelen W, Snel J, Kemper HC. A longitudinal study on smoking in
    relationship to fitness and heart rate response. Medicine & Science in Sports & Exercise. 2003 May.
    49. Asthana A, Piper ME, McBride PE, Ward A, Fiore MC, Baker TB, Stein JH. Long-term effects of
    smoking and smoking cessation on exercise stress testing: three-year outcomes from a randomized clinicaltrial. American heart journal. 2012 Jan 1;163(1):81-7.
    50. Penny WJ, Mir MA. Cardiorespiratory response to exercise before and after acute beta-adrenoreceptor
    blockade in nonsmokers and chronic smokers. International journal of cardiology. 1986 Jun 1;11(3):293-304.
    51. Shetler K, Marcus R, Froelicher VF, Vora S, Kalisetti D, Prakash M, Do D, Myers J. Heart rate recovery:
    validation and methodologic issues. Journal of the American College of Cardiology. 2001 Dec;38(7):1980-7.
    52. Kizilbash MA, Carnethon MR, Chan C, Jacobs DR, Sidney S, Liu K. The temporal relationship
    between heart rate recovery immediately after exercise and the metabolic syndrome: the CARDIA
    study. European heart journal. 2006 Jul 1;27(13):1592-6.
Medical Journal of Mashhad university of Medical Sciences
Volume 63, Issue 4 - Serial Number 4
November and December 2020
Pages 2501-2513