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Somatosensory & Motor Research Volume 36, 2019 - Issue 2
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Original Articles

Effects of transcranial direct current stimulation (tDCS) on balance improvement: a systematic review and meta-analysis

Maria Clara D. Soares de MouraDepartment of Physical Therapy, Communication Sciences and Disorders, and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; Correspondence[email protected]
ORCID Iconhttp://orcid.org/0000-0002-4299-6980
ORCID Icon,
Fuad A. HazimeDepartment of Physical Therapy, Federal University of Piauí, Piauí, Brazil; ORCID Iconhttp://orcid.org/0000-0001-7729-1203
ORCID Icon,
Luana V. Marotti AparicioService of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27) and National Institute of Biomarkers in Psychiatry (INBioN), Department and Institute of Psychiatry, Hospital of Clinics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; ORCID Iconhttp://orcid.org/0000-0002-5362-8462
ORCID Icon,
Luanda A. C. GreccoPhysioterapy Course, University of Sorocaba, Sorocaba, Brazil; ORCID Iconhttp://orcid.org/0000-0003-4449-7429
ORCID Icon,
André R. BrunoniService of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27) and National Institute of Biomarkers in Psychiatry (INBioN), Department and Institute of Psychiatry, Hospital of Clinics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; ;Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, GermanyORCID Iconhttp://orcid.org/0000-0002-6310-3571
ORCID Icon &
Renata Hydeé HasueDepartment of Physical Therapy, Communication Sciences and Disorders, and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; ORCID Iconhttp://orcid.org/0000-0002-7717-6042
ORCID Icon
Pages 122-135 | Received 31 Jan 2019, Accepted 21 May 2019, Published online: 11 Jun 2019
 
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Abstract

Background: Transcranial direct current stimulation (tDCS) has emerged as a promising therapeutic tool to improve balance and optimize rehabilitation strategies. However, current literature shows the methodological heterogeneity of tDCS protocols and results, hindering any clear conclusions about the effects of tDCS on postural control.

Objective: Evaluate the effectiveness of tDCS on postural control, and identify the most beneficial target brain areas and the effect on different populations.

Methods: Two independent reviewers selected randomized tDCS clinical-trials studies from PubMed, Scopus, Web of Science, and reference lists of retrieved articles published between 1998 and 2017. Most frequently reported centre of pressure (COP) variables were selected for meta-analysis. Other postural control outcomes were discussed in the review.

Results: Thirty studies were included in the systematic review, and 11 were submitted to a meta-analysis. A reduction of COP displacement area has been significantly achieved by tDCS, evidencing an improvement in balance control. Individuals with cerebral palsy (CP) and healthy young adults are mostly affected by stimulation. The analysis of the impact of tDCS over different brain areas revealed a significant effect after primary motor cortex (M1) stimulation, however, with no clear results after cerebellar stimulation due to divergent results among studies.

Conclusions: tDCS appears to improve balance control, more evident in healthy and CP subjects. Effects are observed when primary MI is stimulated. Cerebellar stimulation should be better investigated.

Acknowledgements

ARB is recipient of a CAPES/Alexander von Humboldt fellowship award for experienced researchers and a consultant of the Neurocare group GmbH (Munich, Germany).

Disclosure statement

The authors report no conflicts of interest.

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