The Effects Of Temporal Interference Stimulation On Parkinson's Gait: A Pilot Study

Parkinson's Disease (PD) is characterized by the depletion of dopaminergic neurons, resulting in motor symptoms like gait disorder and postural instability. While Deep Brain Stimulation (DBS) effectively modulates the Globus Pallidus internus (GPi) at inhibitory frequencies, typically 130 Hz, its major drawback is invasiveness, involving brain surgery and posing risks of infection, stroke, and surgical complications. Temporal Interference Stimulation (TIs) emerges as a promising non-invasive alternative, showing potential for reaching deep brain regions in PD patients. This pilot study aims to preliminarily assess the efficacy of a standardized TIs protocol. ClinicalTrials.gov identifier: ChiCTR2300077258. PURPOSE: To investigate the immediate effect of GP inhibitory TIs on gait in PD patients. METHODS: This pilot study involves 11 PD patients (H&Y 1.5-2.5, age 72 ± 4.43 years, MoCA 27 ± 1.68) in a randomized, cross-over, double-blind design. Participants receive TIs (130 Hz) or sham intervention randomly with a one-week interval. Assessments, conducted during the medication on-period, include UPDRS-III and Timed Up and Go test (Proto Kinetics Zeno Walkway®) before and after each intervention. A two-way repeated measures ANOVA assesses the impact of different stimuli (stimulation factor × time factor) on dependent variables. The significance level (α) is set at 0.05. RESULTS: Stimulation type had a significant main effect on UPDRS-III (p < 0.05). After TIs, participants showed a significant decrease in UPDRS-III scores (TIs: 44.6 ± 6.0 to 38.5 ± 4.5 vs. sham: 47.5 ± 9.2 to 45.5 ± 6.4, p < 0.05); No significant improvement in Postural Instability and Gait Difficulty (PIGD) sub-item scores was observed, but a decline was noted after TIs (8.0 ± 2.2 to 7.5 ± 1.4, p < 0.05); Gait speed variability showed a time-dependent main effect (p < 0.05), with TIs resulting in a more pronounced decrease (TIs: 4.36 ± 2.85 to 2.76 ± 1.35 vs. sham: 3.55 ± 2.85 to 2.80 ± 2.34); Step length, step width, and step length variability all demonstrated time-dependent main effects (p < 0.05). CONCLUSION: This pilot study indicates GPi TIs as a promising intervention for the gait disorder of PD patients. Future research needs to further investigate how to optimize stimulation parameters and determine the effective duration of stimulation. Supported by the National Natural Science Foundation of China (11932013)