Parkinson's Disease: Enhancing Physical Therapy With Brain Stimulation for Treating Postural Instability.

Prior treatment

• Recent (\<= 2 months) or planned enrollment in an additional physician prescribed physical therapy program during their time in the trial.

Other illness

• Features suggestive of other causes of parkinsonism/Parkinson's-plus syndromes;
• History of deep brain stimulation or brain ablation surgeries, malignant mass brain lesions;
• History of schizophrenia, bipolar illness; history of alcohol/drug abuse within the past 6 months;
• Need for rapid clinical response due to conditions such as initiation, psychosis, or suicidality;
• Unstable medical conditions (e.g., uncontrolled diabetes, uncompensated cardiac issues, heart failure, uncompensated pulmonary disease, or chronic obstructive pulmonary disease);
• Epilepsy or disorders that significantly increase likelihood of seizures including: severe traumatic brain injury, congenital birth defects leading to seizures, brain tumor, metabolic disorders associated with seizures, intracranial or subarachnoid hemorrhage, and nonlacunar strokes.
• Presence of another disorder that might have a significant impact on balance (as assessed by a co-investigator neurologist).

Other

• Contraindications to transcranial brain stimulation or TUS, i.e. metal in the head, implanted brain medical devices, etc.;
• Pregnancy.
• Bed or wheelchair-bound

• Diagnosis of "probable" or "possible" PD, as defined by the current clinical criteria (Gelb D, Oliver E, Gilman S. Diagnostic Criteria for Parkinson's Disease. Arch Neurol.1999;56:33-39) as confirmed by co-investigator neurologist, or confirmation via medical records or a letter from patient physician;
• Complaints about balance impairment or postural instability due to PD (self-report);
• Age from 40 to 90 years old;
• Taking stable medications for PD for at least 30 days.