Transcranial direct current stimulation for Parkinson's disease: a randomized controlled trial (with a sham control)
S. P. Bordovsky,
S. S. Andreev,
R. T. Murtazina,
T. O. Meinova,
A. D. Taranova,
O. O. Zinchenko,
K. V. Shevtsova,
V. A. Parfenov https://doi.org/10.14412/2074-2711-2026-2-11-18
Abstract
Transcranial direct current stimulation (tDCS) of the primary motor cortex is being discussed as an adjunct to therapy for Parkinson's disease (PD). The effectiveness of tDCS in PD remains controversial, and there are no data evaluating the efficacy and safety of tDCS in PD in our country.
Objective: to evaluate the clinical efficacy of a course of anodal tDCS applied to the primary motor cortex as part of a comprehensive treatment regimen for patients with stage II–III PD according to the Hoehn and Yahr scale, including its effects on motor, cognitive and affective symptoms, as well as the safety and tolerability of the method.
Material and methods. A prospective, randomised, controlled trial was conducted involving 46 patients with idiopathic PD (25 men and 21 women; mean age 63.9 ± 11.2 years). The main group (n = 24) received 10 sessions of anodal tDCS to the M1 region (2 mA, 20 min, daily, for 2 weeks), whilst the control group (n = 22) received sham stimulation. The following parameters were assessed before and after the course: motor (Unified Parkinson's Disease Rating Scale – UPDRS; Activity of Daily Living – ADL), cognitive (Montreal Cognitive Assessment – MoCA; Frontal Assessment Battery – FAB; Trail Making Test, Parts A and B – TMT-A, TMT-B; Cue Sensitivity Index of the free recall test with selective cues – CSI) and affective (Starkstein Apathy Scale; Geriatric Depression Scale – GDS; State-Trait Anxiety Inventory – STAI).
Results. After covariate adjustment, a statistically significant between-group advantage of active tDCS was found for 8 of 11 assessed outcomes: UPDRS-III (d = -0.49; p < 0.01), ADL (d = -0.59; p = 0.016), apathy (d = -1.07; p < 0.01), depression according to GDS (d = -0.63; p = 0.013), trait anxiety according to STAI (d = -0.67; p = 0.018), state anxiety according to STAI (d = -0.58; p = 0.041), TMT-A (d = -1.00; p = 0.025), and MoCA (d = 0.52; p = 0.024). The most pronounced effects were observed for apathy and TMT-A. No statistically significant between-group differences after adjustment were found for TMT-B (d = -0.39; p = 0.188), FAB (d = -0.25; p = 0.095), and CSI (d = 0.34; p = 0.29). No serious adverse events were recorded throughout the study period.
Conclusion. Transcranial direct current stimulation (tDCS) of the primary motor cortex has a high safety profile and may be considered as an adjunctive method in the comprehensive rehabilitation of patients with stage II–III PD, with the most pronounced effects observed in the affective domain and in terms of cognitive processing speed.
Keywords
Parkinson's disease,
transcranial direct current stimulation,
tDCS,
neuromodulation,
cognitive impairment,
apathy,
depression,
anxiety,
UPDRS
Supporting agencies: The investigation has not been sponsored
About the Authors
S. P. Bordovsky
First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
Sergey Petrovich Bordovsky
N.V. Sklifosovsky Institute of Clinical Medicine; Department of Nervous Diseases
119021; 11, Rossolimo St., Build. 1; Moscow
Competing Interests:
There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors
S. S. Andreev
HSE University
Russian Federation
Competing Interests:
Russian Federation
Institute for Cognitive Neuroscience; Centre for Cognition and Decision Making
101000; 3, Krivokolenniy Lane; Moscow
Competing Interests:
There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors
R. T. Murtazina
First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
N.V. Sklifosovsky Institute of Clinical Medicine; Department of Nervous Diseases
119021; 11, Rossolimo St., Build. 1; Moscow
Competing Interests:
There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors
T. O. Meinova
First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
N.V. Sklifosovsky Institute of Clinical Medicine; Department of Nervous Diseases
119021; 11, Rossolimo St., Build. 1; Moscow
Competing Interests:
There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors
A. D. Taranova
First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
N.V. Sklifosovsky Institute of Clinical Medicine; Department of Nervous Diseases
119021; 11, Rossolimo St., Build. 1; Moscow
Competing Interests:
There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors
O. O. Zinchenko
HSE University
Russian Federation
Competing Interests:
Russian Federation
Institute for Cognitive Neuroscience; Centre for Cognition and Decision Making
101000; 3, Krivokolenniy Lane; Moscow
Competing Interests:
There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors
K. V. Shevtsova
First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
N.V. Sklifosovsky Institute of Clinical Medicine; Department of Nervous Diseases
119021; 11, Rossolimo St., Build. 1; Moscow
Competing Interests:
There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors
V. A. Parfenov
First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
N.V. Sklifosovsky Institute of Clinical Medicine; Department of Nervous Diseases
119021; 11, Rossolimo St., Build. 1; Moscow
Competing Interests:
There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors
References
1. Luo Y, Qiao L, Li M, et al. Global, regional, national epidemiology and trends of Parkinson's disease from 1990 to 2021: findings from the Global Burden of Disease Study 2021. Front Aging Neurosci. 2024;16:1498756. doi: 10.3389/FNAGI.2024.1498756
2. Su D, Cui Y, He C, et al. Projections for prevalence of Parkinson's disease and its driving factors in 195 countries and territories to 2050: modelling study of Global Burden of Disease Study 2021. BMJ. 2025;388:e080952. doi: 10.1136/BMJ-2024-080952
3. Razdorskaya VV, Voskresenskaya ON, Yudina GK. Parkinson's disease in Russia: prevalence and incidence (review). Saratov Scientific Medical Journal. 2016;12(3):379-84 (In Russ.).
4. Katunina EA, Putyatin IA, Dzugaeva FK, Batsoeva DO. Epidemiology of Parkinson's disease. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;125(11-2):39-54 (In Russ.). doi: 10.17116/jnevro202512511239
5. Antonini A, Emmi A, Campagnolo M. Beyond the Dopaminergic System: Lessons Learned from levodopa Resistant Symptoms in Parkinson's Disease. Mov Disord Clin Pract. 2023;10:S50-5. doi: 10.1002/MDC3.13786
6. Armstrong MJ, Okun MS. Diagnosis and Treatment of Parkinson Disease : A Review. JAMA. 2020;323:548-60. doi: 10.1001/JAMA.2019.22360
7. Nodel MR. Apathy in Parkinson's disease patients. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2014;6(1):80-4 (In Russ.). doi: 10.14412/2074-2711-2014-1-80-84
8. Jellinger KA. Mild cognitive impairment in Parkinson's disease: current view. Front Cognit. 2024;3:1369538. doi: 10.3389/FCOGN.2024.1369538
9. Ren J, Zhang W, Dahmani L, et al. Parkinson's disease as a somato-cognitive action network disorder. Nature. 2026 Feb 4. doi: 10.1038/s41586-025-10059-1. Epub ahead of print.
10. De Micco R, Di Nardo F, Siciliano M, et al. Intrinsic brain functional connectivity predicts treatment-related motor complications in early Parkinson's disease patients. J Neurol. 2024;271:826-34. doi: 10.1007/S00415-023-12020-6
11. Wang Y, Ding Y, Guo C. Assessment of noninvasive brain stimulation interventions in Parkinson's disease : a systematic review and network meta-analysis. Sci Rep. 2024;14(1):14219. doi: 10.1038/s41598-024-64196-0
12. Stagg CJ, Nitsche MA. Physiological basis of transcranial direct current stimulation. Neuroscientist. 2011;17:37-53. doi: 10.1177/1073858410386614
13. Antal A, Alekseichuk I, Bikson M, et al. Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines. Clin Neurophysiol. 2017;128:1774-809. doi: 10.1016/J.CLINPH.2017.06.001
14. Nguyen TXD, Mai PT, Chang YJ, Hsieh TH. Effects of transcranial direct current stimulation alone and in combination with rehabilitation therapies on gait and balance among individuals with Parkinson's disease : a systematic review and meta-analysis. J Neuroeng Rehabil. 2024;21(1):27. doi: 10.1186/s12984-024-01311-2
15. Pol F, Salehinejad MA, Baharlouei H, Nitsche MA. The effects of transcranial direct current stimulation on gait in patients with Parkinson's disease : a systematic review. Transl Neurodegener. 2021;10(1):22. doi: 10.1186/s40035-021-00245-2
16. Ma S, Zhuang W, Wang X, et al. Efficacy of transcranial direct current stimulation on cognitive function in patients with Parkinson's disease : a systematic review and meta-analysis. Front Aging Neurosci. 2025;17:1495492. doi: 10.3389/FNAGI.2025.1495492
17. Li Q, Ye H, Ye C, Huang M. Effects of transcranial direct current stimulation on non-motor functions in individuals with Parkinson's disease : a systematic review and meta-analysis. Front Neurosci. 2025;19:1713623. doi: 10.3389/fnins.2025.1713623
18. Duan Z, Zhang C. Transcranial direct current stimulation for Parkinson's disease : systematic review and meta-analysis of motor and cognitive effects. NPJ Parkinsons Dis. 2024;10:1-14. doi: 10.1038/S41531-024-00821-Z
19. Ni R, Yuan Y, Yang L, et al. Novel Non-invasive Transcranial Electrical Stimulation for Parkinson's Disease. Front Aging Neurosci. 2022;14:880897. doi: 10.3389/fnagi.2022.880897
20. Sarycheva TN. Administration of transcranial electrical stimulation for non-motor symptoms of Parkinson's disease. Bulletin of the Volgograd State Medical University. 2011;(3):36-8 (In Russ.).
21. Pavlova EL, Menshikova AA, Akzhigitov RG, Guekht AB. Transcranial direct current stimulation in neurology and psychiatry. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(12):123-30 (In Russ.). doi: 10.17116/jnevro2020120121123
22. Starkstein SE, Mayberg HS, Preziosi TJ, et al. Reliability, validity, and clinical correlates of apathy in Parkinson's disease. J Neuropsychiatry Clin Neurosci. 1992;4:134-9. doi: 10.1176/JNP.4.2.134
23. Beretta VS, Orcioli-Silva D, Zampier VC, et al. Eight sessions of transcranial electrical stimulation for postural response in people with Parkinson's disease: A randomized trial. Gait Posture. 2024;114:1-7. doi: 10.1016/J.GAITPOST.2024.08.076
24. Zhang B, Huang F, Liu J, Zhang D. Bilateral transcranial direct current stimulation may be a feasible treatment of Parkinsonian tremor. Front Neurosci. 2023;17:1101751. doi: 10.3389/fnins.2023.1101751
25. Suarez-Garcia DMA, Grisales-Cardenas JS, Zimerman M, Cardona JF. Transcranial Direct Current Stimulation to Enhance Cognitive Impairment in Parkinson's Disease : A Systematic Review and Meta-Analysis. Front Neurol. 2020;11:597955. doi: 10.3389/fneur.2020.597955
26. De Souza Souto JJ, Edite Case de Oliveira M, Silva GM, et al. Transcranial direct current stimulation and cognitive changes in Parkinson's disease, a systematic review with meta-analysis and meta-regression. Appl Neuropsychol Adult. 2024 Jul 5:1-11. doi: 10.1080/23279095.2024.2367108
27. Haber SN. Corticostriatal circuitry. Dialogues Clin Neurosci. 2016;18:7-21. doi: 10.31887/DCNS.2016.18.1/SHABER
28. Kwon DY, Song JH, Yoon HK. Improvement of depression and motor parameters after application of transcranial direct current stimulation in Parkinson's disease. Parkinsonism Relat Disord. 2025;134:107596. doi: 10.1016/j.parkreldis.2025.107596
29. Beheshti I, Ko JH. Modulating brain networks associated with cognitive deficits in Parkinson's disease. Mol Med. 2021;27:24. doi: 10.1186/S10020-021-00284-5
30. Qi S, Cao L, Wang Q, et al. The Physiological Mechanisms of Transcranial Direct Current Stimulation to Enhance Motor Performance : A Narrative Review. Biology. 2024;13(10):790. doi: 10.3390/biology13100790
Review
For citations:
Bordovsky SP, Andreev SS, Murtazina RT, Meinova TO, Taranova AD, Zinchenko OO, Shevtsova KV, Parfenov VA. Transcranial direct current stimulation for Parkinson's disease: a randomized controlled trial (with a sham control). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2026;18(2):11-18. (In Russ.) https://doi.org/10.14412/2074-2711-2026-2-11-18
Views:
931
JATS XML
Email this article 