How walking skills transfer from split-belt treadmill to overground walking in Parkinson's
Neural Mechanism of Skill Transfer in Parkinson's Disease
This project will test whether stimulating a brain area called the posterior parietal cortex with repeated TMS helps people with Parkinson's transfer improvements from split-belt treadmill training to normal overground walking.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 24 (estimated) |
| Ages | 50 Years and up |
| Sex | All |
| Sponsor | McGill University Academic / other |
| Locations | 1 site (Montreal, Quebec) |
| Trial ID | NCT07351032 on ClinicalTrials.gov |
What this trial studies
Researchers will apply repeated transcranial magnetic stimulation (rTMS) to the posterior parietal cortex (PPC) and compare active versus sham stimulation effects on gait transfer in people with Parkinson's. Participants visit the lab three times: the first for clinical assessments and to map TMS targets and thresholds, and two further visits at least 48 hours apart for crossover rTMS-active and rTMS-sham sessions. On each intervention day they perform pre-overground walking and split-belt treadmill (SBT) adaptation tests, have cortical excitability measured with a dual-coil setup, receive rTMS or sham, then complete 30 minutes of SBT training while gait parameters are recorded before and after. The primary comparison is the change in gait measures from pre- to post-intervention between the active and sham conditions to determine whether PPC upregulation improves transfer of treadmill-adapted walking to overground walking.
Who should consider this trial
Good fit: Ideal participants are people with idiopathic Parkinson's disease who do not have freezing of gait, have normal cognition (MoCA ≥ 25), can walk independently for 30 minutes, have no DBS implant, and have no significant orthopedic or vestibular problems.
Not a fit: People with implanted deep brain stimulators, significant freezing of gait, cognitive impairment, severe dyskinesia or other conditions that prevent safe walking are unlikely to benefit or be eligible.
Why it matters
Potential benefit: If successful, this approach could make treadmill-based gait training translate better into everyday walking, potentially reducing gait asymmetry and fall risk.
How similar studies have performed: Split-belt treadmill training has been shown to change gait patterns in Parkinson's, and rTMS has altered motor cortical excitability in other contexts, but applying rTMS to the PPC specifically to boost transfer from SBT to overground walking is a relatively new and unproven approach.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * a confirmed diagnosis of idiopathic Parkinson's disease * absence of freezing of gait confirmed by a "No" answer to the second item of the New Freezing of Gait Questionnaire (NFOGQ) and no observation of FOG during a freezing provoking test * no other neurological diagnosis * no severe musculoskeletal/orthopedic or vestibular condition that interferes with walking and or significantly affects balance * no mild cognitive impairment (Montreal Cognitive Assessment ≥ 25) * able to walk independently and without assistive device for 30 minutes * no previous experience with split-belt treadmill. Exclusion Criteria: * severe dyskinesia that interacts with walking and balance hearing or visual impairment * observed inability to walk safely on a tied-belt treadmill * neurological disorders other than PD or other pathology (e.g., orthopedic) interfering with mobility. - contradiction for TMS * implanted deep brain stimulator.
Where this trial is running
Montreal, Quebec
- McGill University - Currie Gymnasium — Montreal, Quebec, Canada (Recruiting)
Study contacts
- Principal investigator: Caroline Paquette, PhD — McGill University
- Study coordinator: Tomoha Ogawa, BA
- Email: hbcl@mcgill.ca
- Phone: 514-398-2488
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.