Title: Feasibility of remote transcranial direct current stimulation for pediatric cerebral palsy during the COVID-19 pandemic
Legend: Fig. 1a. Line plot showing the mean time to set up the modified tDCS headgear was reduced each day. The variability in setup time across participants was also reduced as experience with the device increased. ∗p < 0.05 b. Examples and ratings for tDCS workflow steps over the three days. c. Individual feedback about comfort of
Citation: Lench, DH, Simpson, EA, Sutter, EN, Gillick, BT. ‘Feasibility of remote transcranial direct current stimulation for pediatric cerebral palsy during the COVID-19 pandemic’. Brain Stimulation, 2020 Nov: 13(6):1803-1804.
Abstract: Cerebral palsy is caused by a congenital brain lesion that occurs early in life with associated motor deficits which may result in lifelong disability. The brain has high neuroplastic potential early in life, stressing the importance for therapy. Non-invasive brain stimulation (NIBS) including transcranial direct current stimulation (tDCS) may enhance pediatric rehabilitation interventions through neuroplasticity. The Gillick laboratory has previously demonstrated that tDCS is safe, feasible, and successful at modifying motor performance in children with CP in the research setting. We studied the feasibility of remote tDCS in a pediatric 2 population due to the increasing need to enhance rehabilitation research for children with limited access to in person therapies, especially during the COVID-19 pandemic. The efficiency, quality, and comfort of unstimulated tDCS administration performed by a “parent-child team” was evaluated. Participants used the Soterix Medical tDCS SNAPstrap and inactive mini-CT device to perform steps including headgear setup, application of sponge electrodes, and connection of the mini-CT device over three consecutive days with the guidance of instructional videos. The efficiency of the tDCS workflow improved by nearly 50% after the first two days; it was performed 294 seconds faster on day three than on day one. The quality analysis revealed parent child teams correctly positioned the device on the scalp across multiple days. The headgear was slightly uncomfortable for 5/7 participants. Parent-child teams have the ability to perform the steps required for remote tDCS. Future studies with monitored remote tDCS stimulation will increase accessibility to NIBS during and after the COVID19 pandemic.
About the Lab: Bernadette Gillick’s laboratory at the Waisman Center investigates how the brain simultaneously develops and recovers after perinatal stroke in early infancy. Further, Gillick’s team investigates interventions using combined non-invasive brain stimulation with neurorehabilitation to optimize functional outcomes in children with cerebral palsy due to perinatal stroke. By understanding the patterns of brain recovery and the optimal timing of intervention, Gillick aims to improve functional outcomes early in life, for improved lifelong activity and participation.