AUTHOR=Shima Atsushi , Tanaka Kazuki , Ogawa Akari , Omae Erika , Miyake Tomoaki , Nagamori Yui , Miyata Yusuke , Ohata Koji , Ono Yumie , Mima Tatsuya , Takahashi Ryosuke , Koganemaru Satoko TITLE=Case report: Backward gait training combined with gait-synchronized cerebellar transcranial alternating current stimulation in progressive supranuclear palsy JOURNAL=Frontiers in Human Neuroscience VOLUME=17 YEAR=2023 URL=https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2023.1082555 DOI=10.3389/fnhum.2023.1082555 ISSN=1662-5161 ABSTRACT=

Progressive supranuclear palsy (PSP) is characterized by recurrent falls caused by postural instability, and a backward gait is considered beneficial for postural instability. Furthermore, a recent approach for rehabilitation combined with gait-oriented synchronized stimulation using non-invasive transcranial patterned stimulation could be promising for balance function. Here, we present a case of PSP with backward gait training combined with gait-synchronized transcranial alternating current stimulation (tACS). A 70-year-old woman with PSP-Richardson’s syndrome underwent backward gait training combined with synchronized cerebellar tACS. Initially, she underwent short-term intervention with combined training of backward gait with synchronized cerebellar tACS, asynchronized, or sham stimulation according to the N-of-1 study design. Synchronized tACS training demonstrated a decrease in postural instability, whereas asynchronized or sham stimulation did not. The additional long-term interventions of combined backward gait training with synchronized cerebellar tACS demonstrated further decrease in postural instability with improvements in gait speed, balance function, and fall-related self-efficacy in daily life. The present case describes a novel approach for motor symptoms in a patient with PSP. Backward gait training with synchronized cerebellar tACS may be a promising therapeutic approach.