ArticleMovement disorders clinical practice2026
A Randomized Controlled Trial of Dual Upper-Extremity Training [DUET]: Combining Neurologic Music Therapy® with Noninvasive Brain Stimulation for Upper-Limb Performance in Corticobasal Syndrome.
Article in Movement disorders clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCorticobasal syndrome (CBS) is a progressive neurodegenerative condition characterized by asymmetric limb rigidity, apraxia, dystonia, and myoclonus, with no approved symptomatic or disease-modifying drug treatments. Neurologic music therapy (NMT)® employs evidence-based techniques targeting sensorimotor rehabilitation, and high-definition transcranial direct current stimulation (HD-tDCS) modulates cortical excitability.
objectivesThe objective was to evaluate the preliminary efficacy of active-HD-tDCS + NMT versus sham-HD-tDCS + NMT for upper-limb motor performance in individuals with CBS.
methodsIn this single-center, sham-controlled, triple-masked randomized trial, 20 CBS participants received active HD-tDCS + NMT (n = 10) or sham HD-tDCS + NMT (n = 10) across six 30-minute sessions over 3 weeks. Primary outcomes included Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and Purdue Pegboard Test (PPT). Secondary outcomes assessed CBS-specific function, praxis, cognition, and anxiety. Linear mixed-effects models examined the main and interaction effects of group (active vs. sham) and time (baseline, postintervention, follow-up), with sex and years since diagnosis as covariates.
resultsWe found no significant main effect of group but a significant main effect of timepoint, with significant improvements from T1 to T2 and T3 on the BBT, PPT, and WMFT, along with reductions in anxiety scores. The WMFT additionally showed a significant group × time interaction, reflecting differing longitudinal patterns of change across groups. Significant within-group improvements were observed in the active HD-tDCS group (ΔM = 6.30 at T1-T2, P = 0.0002, d = 1.35; ΔM = 7.20 at T1-T3, P = 0.0001, d = 1.54), although between-group differences at individual timepoints were not statistically significant.
conclusionBoth NMT alone and combined NMT + HD-tDCS were feasible in CBS and were associated with improvements in selected upper-limb motor outcomes, although findings varied across assessments. The results further suggest a possible additive benefit of concurrent HD-tDCS and NMT, warranting larger controlled trials.
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