{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:04:53Z","timestamp":1791288293812,"version":"4.3.0"},"reference-count":77,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurorehabil Neural Repair"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Parkinson\u2019s impairs movement control and proprioception. This pilot randomized controlled trial investigated whether anodal transcranial direct current stimulation (a-tDCS) combined with proprioceptive exercises improves these functions in people with Parkinson\u2019s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-four people with Parkinson\u2019s were randomly assigned (1:1) to either active a-tDCS (2mA, 20\u2009minutes, 3 sessions\/week for 2\u2009weeks) or sham stimulation, followed by standardized proprioceptive training. The primary outcome was ankle joint proprioceptive acuity. Secondary outcomes included postural sway, gait initiation parameters, and quality of life. Participants were blinded to group allocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The active a-tDCS group showed significantly greater improvement in ankle joint repositioning error compared to the sham group (mean difference \u22122.9 degrees, 95% CI [\u22123.1, \u22122.7];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.012). Postural sway (elliptical sway area, eyes closed) was also significantly reduced in the active a-tDCS group (\u22122.6\u2009cm\u00b2, 95% CI [\u22124.6, \u22120.6];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.038). Gait initiation time decreased in both groups, but only the active a-tDCS group showed a significant reduction in step time (\u2212168\u2009ms, 95% CI [\u2212175, \u2212160];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.005). No significant between-group difference was found in quality of life (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.687).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Multiple sessions of a-tDCS combined with proprioceptive exercises explored preliminary evidence of enhanced proprioceptive acuity and postural control in people with Parkinson\u2019s. Gait initiation also improved with a-tDCS. All a-tDCS sessions were well-tolerated by participants, with no adverse effects reported. Further research is needed to explore long-term effects and underlying mechanisms. This pilot study provides preliminary evidence for a-tDCS as a potential adjunctive therapy, though larger trials are needed to confirm clinical efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration code:<\/jats:title>\n                    <jats:p>IRCT20230820059201N2 (Iranian Registry for Clinical Trials)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration URL:<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/irct.behdasht.gov.ir\/trial\/76791\">https:\/\/irct.behdasht.gov.ir\/trial\/76791<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration Name:<\/jats:title>\n                    <jats:p>Effect of Adding Trans-Cranial Direct Current Stimulation on Supplementary Motor Area to Exercise Therapy on Proprioception Acuity, Postural Control, Initiation of Gait, and Brain Cortical Activity in People with Parkinson\u2019s<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15459683251363242","type":"journal-article","created":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T04:34:40Z","timestamp":1755405280000},"page":"906-919","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Transcranial Direct Current Stimulation on Supplementary Motor Area Enhances the Effects of Exercise Therapy for Proprioception and Balance in People with Parkinson\u2019s: an Exploratory Pilot Trial"],"prefix":"10.1177","volume":"39","author":[{"given":"Hasti","family":"Heydarpour","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2745-0058","authenticated-orcid":false,"given":"Mohammed N.","family":"Ashtiani","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Bahrpeyma","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Tafakhori","sequence":"additional","affiliation":[{"name":"Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shapour","family":"Jaberzadeh","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Non-invasive Brain Stimulation &amp; Neuroplasticity Laboratory, Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,16]]},"reference":[{"key":"e_1_3_2_2_2","article-title":"The emerging evidence of the Parkinson pandemic","volume":"8","author":"Dorsey ER","year":"2018","unstructured":"Dorsey ER, Sherer T, Okun MS, Bloem BR. 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