ACUTE EFFECT OF HD-TDCS NEUROMODULATION ON THE SUPPLEMENTARY MOTOR AREA IN PATIENTS WITH PARKINSON'S DISEASE AND ITS INFLUENCE ON COGNITIVE-MOTOR CONFLICT TASKS IN STEP INITIATIONS AND ITS PREFRONTAL CORTICAL CORRELATES
With the progression of Parkinson's disease (PD), in addition to the dopaminergic circuit, other neural circuits are involved. As a result, the executive inhibition functions become progressively compromised and correlate with motor functions. During step initiation, the nervous system organizes a series of anticipatory postural adjustments (APAs) to counterbalance the forces generated by voluntary movement, ensuring stability. Recent studies point to the neural circuitry involving the supplementary motor area (SMA) as a fundamental region for the modulation of APAs. Associated with this, studies have shown an increase in the participation of prefrontal regions as compensation for the decrease in the circuitry involved with the modulation of automatic movements. Some preliminary studies suggest that direct current brain stimulation (tDCS) may positively affect motor and cognitive symptomatology in PD. This work aims to evaluate the acute effect of tDCS on the AMS in the modulation of the cognitive areas of the prefrontal cortex and the performance of step initiation in a cognitive-motor conflict task in patients with PD. Therefore, a triple-blind crossover study will be carried out with 24 volunteers with PD without freezing of gait, who will be submitted to two sessions of tDCS, one anodic (2 mA, 20 min) and the other placebo on AMS. Kinetic and kinematic analyses will be performed, synchronized with recording the hemodynamic response by functional near-infrared spectroscopy (fNIRS), pre- and post-neuromodulation, during the step initiation activity with cognitive conflict.