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Table 4 Intervention protocols and results in studies that targeted the DLPFC

From: The effects of transcranial direct current stimulation on gait in patients with Parkinson’s disease: a systematic review

Study

Polarity of target electrode

Electrode size (cm2)

Intensity (mA)

Current density (mA/cm2)

Current density (mA/cm2)

Duration (min)

Number of sessions

Anatomical target (target electrode placement)

Target electrode placement

Return electrode placement

State of medication during intervention

Combined intervention

Online/offline tDCS

Adverse effects

Outcome measurements

Time points of assessment

State of medication during assessment

Results

Conclusion

Effect size (type)

Bueno et al. 2019 [42]

Anode

T = R = 5 × 7

2

0.06

0.06

20

1

DLPFC (F3)

F3

Fp2

NR

Offline

NR

TUG; Video gait analysis for time to cover a particular distance, gait speed, number of steps

Before, after

On

No improvement in TUG time and data from video gait analysis

NR

Chang et al. 2017 [43]

Anode

T = R = 5 × 5

1

0.04

0.04

20

5 consecutive days

DLPFC (F3)

F3

Contralateral supraorbital

On

Repetitive transcranial magnetic stimulation with 10 Hz frequency

Online

Headache

FoG questionnaire, modified Standing-Start 180° Turn Test (turning steps and turning time); TUG

Before, immediately and 1 week after 5 sessions of intervention

On

Significant improvement in FoG and ambulatory function in both groups. No significant difference in the between-group analyses

NR

Criminger et al. 2018 [51]

Anode, cathode

T = R = 3 × 5

2

0.13

0.13

20

1

DLPFC (F3,F4)

F3, F4

F3, F4

On

Stationary bicycling; playing a video game of golf on Wii™

Online

Headache

TUG in ST and DT conditions

Before, after

On

No significant effect of tDCS on TUG

NR

Dagan et al. 2018 [44]

Anode

T = R = 3 (Pi-electrodes)

Max = 1.5

0.33

0.33

20

1

M1, DLPFC (AF4, CP1, F3, FC1, FC5, Cz)

AF4, CP1, F3, FC1, FC5, Cz

NR

NR

Offline

NR

FOG-provoking test; gait speed in 40 m walking, TUG

Before, after

NR

TUG, gait speed in 40 m and FoG improved by only multitarget stimulation

M1 alone: →; M1 and DLPFC: ↑

NR

Lattari et al. 2016 [45]

Anode

T = R = 5 × 7

2

0.06

0.06

20

1

DLPFC (F3)

F3

Contralateral supraorbital

NR

Offline

Tingling, itching

Dynamic Gait Index; TUG

before, after

NR

Improvement in dynamic gait index and TUG

NR

Manenti et al. 2014 [47]

Anode

T = R = 5 × 7

2

0.06

0.06

7

1

DLPFC (F3 or F4)

F3 or F4

Contralateral supraorbital

On

Offline

No

TUG

Before, after

On

Decrease in TUG time comparing tDCS over F4 vs. sham tDCS

NR

Mishra et al. 2021 [39]

Anode

T = R = 5 × 7

2

0.06

0.06

30

1

DLPFC (F3)

F3

Contralateral supraorbital

On

Online/offline

Speed

Before, during, immediately, 15 min, and 30 min after stimulation under ST and DT conditions

On

Improvement of gait under DT condition

NR

Swank et al. 2016 [52]

Anode

NR

2

20

1

DLPFC (F3)

F3

F4

On

Offline

NR

TUG under three conditions: alone, with motor task, with cognitive task

Immediately after

On

No significant differences

0.07 to 0.45

(Glass’ Δ)

  1. T target electrode, R reference electrode; M1 primary motor cortex; F3 left DLPFC; F4 right DLPFC; DLPFC dorsolateral prefrontal cortex; Fp2 right supraorbital area; NR not reported; ↑: positive effect; →: no effect; TUG timed up and go; NR not reported; ST single task; DT dual task; FoG freezing of gait; tDCS transcranial direct current stimulation