The Effect of Repetitive Transcranial Direct Current Stimulation versus Botulinum Toxin Therapy on Focal Dystonias

Abstract

Dystonia is a movement disorder which presents itself as a loss of voluntary motor control due to involuntary movements and abnormal postures. This disorder represents one of the most disabling conditions as yet to be resolved in the field of neurology. The current perspective about dystonia is being a motor circuits disorder rather than a regional brain disorder. Neurophysiological studies confirmed presence of cortical hyper-excitability in dystonic patient. Transcranial direct current stimulation (tDCS) is a non-invasive tool to guide neuroplasticity and modulate cortical function by a tonic stimulation with weak direct currents. Anodal tDCS enhances cortical excitability, whereas cathodal tDCS reduces it. This thesis aims to investigate the effects of tDCS as new treatment approach for focal dystonia as no current therapeutic modality fits to all. The thesis addresses the question whether an eight sessions of cathodal tDCS over the primary motor cortex reduces duration, severity and pain in focal cervical, upper limb and lower limb dystonias. We chose to compare the effect of