Exploring the impact of tDCS on corticospinal excitability and balancing cortical inhibitory and facilitatory mechanisms in individuals with COPD.

Objective: To explore the effects of Transcranial Direct Current Stimulation (tDCS) on corticospinal excitability and the balance between cortical inhibitory and facilitatory mechanisms in individuals with Chronic Obstructive Pulmonary Disease (COPD). Design: A randomized, controlled, double-blind study. Participants: COPD Group: 20 diagnosed COPD patients, stages II-IV. Control Group: 25 healthy, age-matched individuals. Exclusion Criteria: Current smokers, history of neurological disorders, contraindications to tDCS or TMS. Intervention: tDCS: 2 mA stimulation over the primary motor cortex (M1) for 20 minutes. Sham: Identical setup with the stimulator turned off after 30 seconds. Sessions: Five sessions over one week, with assessments at baseline, immediately post-intervention, and one month later. Measures: TMS Assessments: Motor Evoked Potentials (MEPs), Cortical Silent Period (CSP), Short Intracortical Inhibition (SICI), and Intracortical Facilitation (ICF) to evaluate corticospinal excitability and cortical mechanisms. COPD Assessment: Spirometry to assess lung function. Data Analysis: Within and between-group comparisons using repeated-measures ANOVA for TMS parameters and lung function. Post-hoc analyses with Bonferroni correction for multiple comparisons. Ethics: Ethical approval from the relevant Institutional Review Board and informed consent from all participants. Expected Outcome: Understanding the impact of tDCS on enhancing corticospinal excitability and modulating inhibitory and facilitatory cortical mechanisms in COPD patients. Insights into tDCS as a potential non-pharmacological intervention for management of COPD symptoms.