Transcranial direct current stimulation for the treatment of focal hand dystonia |
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| Authors: | David H Benninger MD Mikhail Lomarev MD Grisel Lopez MD Natassja Pal David A Luckenbaugh Mark Hallett MD |
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| Institution: | 1. Medical Neurology Branch, National Institutes of Health, Bethesda, Maryland, USA;2. Department of Neurology, University Hospital of Basel, Basel, Switzerland;3. St. Petersburg V.M. Bekhterev Psychoneurological Research Institute, Saint‐Petersburg, Russia;4. National Institute of Neurological Disorders and Stroke and National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA |
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| Abstract: | The treatment of writer's cramp, a task‐specific focal hand dystonia, needs new approaches. A deficiency of inhibition in the motor cortex might cause writer's cramp. Transcranial direct current stimulation modulates cortical excitability and may provide a therapeutic alternative. In this randomized, double‐blind, sham‐controlled study, we investigated the efficacy of cathodal stimulation of the contralateral motor cortex in 3 sessions in 1 week. Assessment over a 2‐week period included clinical scales, subjective ratings, kinematic handwriting analysis, and neurophysiological evaluation. Twelve patients with unilateral dystonic writer's cramp were investigated; 6 received transcranial direct current and 6 sham stimulation. Cathodal transcranial direct current stimulation had no favorable effects on clinical scales and failed to restore normal handwriting kinematics and cortical inhibition. Subjective worsening remained unexplained, leading to premature study termination. Repeated sessions of cathodal transcranial direct current stimulation of the motor cortex yielded no favorable results supporting a therapeutic potential in writer's cramp. © 2011 Movement Disorder Society |
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| Keywords: | transcranial direct current stimulation (tDCS) noninvasive brain stimulation therapeutic study focal hand dystonia |
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