Non-invasive Brain Stimulation for the Treatment of Mild Cognitive Impairment in Parkinson's Disease

Korábbi kezelés

• Indication of alcohol or drug abuse;
• Contra-indication for MR imaging:
  • metal in the body (pacemaker, port-a-cath, prosthesis, (cochlear) implant)
  • previous brain surgery
  • head trauma that resulted in unconsciousness for at least 1 hour
  • clips
  • (old metal containing) tattoo
  • irremovable piercings
  • irremovable metal braces
  • pregnancy
  • claustrophobia other problems lying still for 45 minutes
  • metal in the teeth
  • neurostimulator (including deep brain stimulation)

Más betegség

• Indication for dementia based on the SAGE (cut-off ≤ 14; Scharre et al., 2010);
• Severe depressive disorder (Beck Depression Inventory - Ib score > 18);
• Psychotic disorder (except for benign hallucinations with insight), screened with the Scale for Assessment of Positive Symptoms for Parkinson's disease;

Életkor

• Contra-indication for rTMS according to Magstim Rapid2 Manual; rTMS should not be:
  • used on or in the vicinity of patients or users with cardiac demand pacemakers, implanted medication pumps, cochlear devices, implanted defibrillators and/or implanted neurostimulators
  • used on or in the vicinity of patients with implanted metal objects• used on patients where the skin in the area to be contacted is broken
  • used on those with large ischaemic scars
  • used on pregnant women
  • used on infants under the age of 2 years
  • used on epileptic individuals
  • used on those with a family history of convulsions
  • used on individuals with brain lesions that could affect seizure threshold
  • used on individuals suffering from multiple sclerosis
  • used on individuals taking tricyclic antidepressants, neuroleptic agents or any other drug that could lower seizure threshold,
  • used on individuals suffering from sleep deprivation during rTMS procedures
  • used on individuals with a heavy consumption of alcohol or those using epileptogenic drugs
  • used on individuals with severe heart disease or with increased intracranial pressure be used on those who have uncontrolled migraines
• Contra-indication for tDCS according to Neuroelectrics Starstim Manual; tDCS should not be used in case of:
  • Patients with a history of seizures;
  • Patients with unexplained episodes of loss of consciousness, since such condition could be related with brain alterations or epilepsy;
  • Patients with unstable or non-controlled neuropsychiatric illness;
  • Patients having implanted brain medical devices;
  • Patients with implanted pacemakers;
  • Patients having any electrically, magnetically or mechanically activated implant;
  • Patients having cardiac, neural or medication implants;
  • Patients having vascular clips or any other electrically sensitive support system in the brain;
  • Patients with serious brain injury;
  • Patients showing damage of skin at sites of stimulation (the device can only be used in healthy skin without wounds, otherwise the resistance to current can be altered);
  • Patients suffering from skin problems, such as dermatitis, psoriasis or eczema;
  • Patients suffering from severe or frequent headaches;
  • Patients with any serious life-threatening disease such as congestive heart failure, pulmonary obstructive chronic disease or active neoplasia;
  • Pregnant women (women of childbearing age should undertake a pregnancy test to confirm eligibility before treatment).

Egyéb

• Space-occupying lesion on MRI.

• Clinical diagnosis of Parkinson's disease, diagnosed by a neurologist;
• Mild to moderate disease stage (Hoehn \& Yahr disease stage < 4);
• Movement Disorders Society level I criteria for PD-MCI (Litvan et al., 2012):
  • Montreal Cognitive Assessment score range [21-25] (Dalrymple-Alford et al., 2010), or
  • performance 1-2 SD below appropriate norms on at least 2 neuropsychological tests, or
  • classification of PD-MCI based on recent (< 6 months previous to participation) neuropsychological assessment taken elsewhere (report will be requested);- In case of (dopaminergic) medication use, participants are on stable medication for at least one month before participation and expect to remain on stable medication during the study