Remotely-supervised Transcranial Direct Current Stimulation (tDCS) for At-home Treatment of Fatigue and Cognitive Slowing in Parkinson's Disease

Inclusion criteria

• Diagnosis of PD confirmed by neurologist;
• Parkinson fatigue scale binary coding scoring a score of > 7;
• Able to understand the informed consent process and provide consent to participate in the study
• Has stable and continuous access to internet service at home compatible with the study laptop (Wi-Fi or ethernet cable)
• Adequate internet capacity for remote monitoring, as tested by http://www.speedtest.net/)
• Subjects who are stable in their PD medication for 2 or more weeks prior to enrollment.

Exclusion criteria

• Visual, auditory and motor deficits that would prevent full ability to understand study instructions or operate the tDCS device or study laptop, as judged by treating neurologist or study staff
• Current chronic headaches or migraines. In addition, if a subject has had a change in the rate or severity of head pressure, headache, or migraine in the past two weeks, they are excluded.
• History of significant head trauma (e.g., brain injury, brain surgery) or medical device implanted in the head (such as Deep Brain Stimulator) or in the neck (such as a Vagus Nerve Stimulator)
• Any skin disorder/sensitive skin (e.g., eczema, severe rashes, blisters, open wounds, burn including sunburns, cuts or irritation, or other skin defects) which compromise the integrity of the skin at or near stimulation locations where electrodes are placed
• Serious uncontrolled medical condition (e.g., cancer or acute myocardial infarction)
• Alcohol or other substance use disorder
• Hoehn and Yahr score >3
• Pregnant or breastfeeding
• History of dementia or Montreal Cognitive Assessment (MoCA) score <20
• Not capable of passing the neuropsychology /computer and tDCS aptitude test
• Unable to tolerate discomfort from the tDCS tolerability stimulation test