Abstract
Background: The cerebellar cognitive affective syndrome (CCAS) encompasses cognitive and affective symptoms in patients with cerebellar disorders, for which no proven treatment is available.
Objectives: Our primary objective was to study the effect of cerebellar anodal transcranial direct current stimulation (tDCS) on cognitive performance in CCAS patients. Secondary effects on ataxia severity, mood, and quality of life were explored.
Methods: We performed a randomized, double-blind, sham-controlled trial. Thirty-five patients with CCAS were included and received 10 sessions of 20 minutes sham (n = 17) or real (n = 18) tDCS, with a current of 2 mA. Cognitive performance was assessed using executive function subtests of the computerized Test of Attentional Performance (TAP), with the composite as primary endpoint. Secondary outcomes were ataxia severity, mood, and quality of life. Outcomes were evaluated 1, 3, 6, and 12 months post-intervention.
Results: Cerebellar tDCS was well tolerated and no serious adverse events related to the intervention occurred. No significant tDCS effect was found on cognitive performance. Improvement on the TAP was observed in the sham group 1 month post-treatment (estimate = −0.248, 95% CI, −0.49 to −0.01), but not clinically relevant. A positive tDCS effect was observed for ataxia severity 1 month post-treatment (estimate = −0.985, 95% CI, −1.94 to −0.03).
Conclusions: Ten sessions of 20 minutes cerebellar anodal tDCS did not prove efficacious for CCAS-related cognitive impairment, but a significant positive effect of tDCS was found for ataxia severity, aligning with previous findings indicative of tDCS as a therapeutic neuromodulation tool in cerebellar disorders.
Original language | English |
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Number of pages | 12 |
Journal | Movement Disorders |
DOIs | |
Publication status | E-pub ahead of print - 2 Nov 2024 |
Bibliographical note
Publisher Copyright:© 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Funding
B.v.d.W. reports grants from ZonMw, Dutch Scientific Organization, Gossweiler Foundation, Chistina Foundation, and Hersenstichting. B.v.d.W. has received consulting fees from Biohaven Pharmaceuticals, Biogen, and VICO Therapeutics. B.v.d.W. has received royalty payments from BSL/Springer Nature and honoraria from MDC Malaysia and the International Parkinson and Movement Disorder Society. B.v.d.W. participates in the scientific advisory board of Biogen and VICO Therapeutic, and the medical advisory boards for Dutch patient organizations for ataxia and for HSP. F.E.d.L. reports grants from the Dutch Heart Foundation and ZonMw. F.E.d.L. is Associate editor for the International Journal of Stroke. R.M. reports grants from the National Ataxia Foundation, Ataxia UK, Friedreich's Ataxia Research Alliance, and Stichting Friedreich Ataxie Nederland. R.P.C.K., D.J.L.G.S., S.F.I.R., and S.T. have no disclosures to report. Potential conflict of interest Financial support was provided by a grant from the Hersenstichting Nederland (grant number DR\u20102019\u201000313). Funding agency
Funders | Funder number |
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Hersenstichting | DR-2019-00313 |
Keywords
- cerebellar cognitive affective syndrome
- Cerebellum
- cognition
- neuromodulation
- transcranial direct current stimulation