Enhancing low-frequency oscillations using on-demand direct-current stimulation improves motor function after stroke

Objective.We compared the effects of transcranial direct current stimulation at different cortical sites (premotor and motor primary cortex) combined with constraint-induced movement therapy for treatment of stroke patients.Design.Sixty patients were randomly distributed into 3 groups: Group A, anodal stimulation on premotor cortex and constraint-induced movement therapy; Group B, anodal stimulation on primary motor cortex and constraint-induced movement therapy; Group C, sham stimulation and constraint-induced movement therapy. Evaluations involved analysis of functional independence, motor recovery, spasticity, gross motor function, and muscle strength.Results.A significant improvement in primary outcome (functional independence) after treatment in the premotor group followed by primary motor group and sham group was observed. The same pattern of improvement was highlighted among all secondary outcome measures regarding the superior performance of the premotor group over primary motor and sham groups.Conclusions.Premotor cortex can contribute to motor function in patients with severe functional disabilities in early stages of stroke. This study was registered in ClinicalTrials.gov database (NCT 02628561).

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Enhancement of non-dominant hand motor function by anodal transcranial direct current stimulation

Neuroscience Letters ◽

10.1016/j.neulet.2006.05.051 ◽

2006 ◽

Vol 404 (1-2) ◽

pp. 232-236 ◽

Cited By ~ 210

Author(s):

Paulo S. Boggio ◽

Letícia O. Castro ◽

Edna A. Savagim ◽

Renata Braite ◽

Viviane C. Cruz ◽

...

Keyword(s):

Motor Function ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Dominant Hand ◽

Direct Current Stimulation

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Effect of Transcranial Direct Current Stimulation associated with aerobic exercise on the autonomic modulation of hemiparetic individuals due to stroke: a study protocol for a double-blind randomized controlled trial

F1000Research ◽

10.12688/f1000research.36394.2 ◽

2021 ◽

Vol 10 ◽

pp. 191

Author(s):

Solange Zilli Lo Presti Heinz ◽

Katia De Angelis ◽

Glauber Heinz ◽

Ariane Viana ◽

Fernanda Marciano Consolim-Colombo ◽

...

Keyword(s):

Aerobic Exercise ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Exercise Intervention ◽

Low Frequency ◽

Chronic Stroke ◽

Pulse Interval ◽

Clinical Test ◽

Direct Current Stimulation ◽

Risk Of Death

Background: Individuals after a stroke have an imbalance in the autonomic nervous system, which increases the risk of death or recurrent episodes of stroke. Transcranial Direct Current Stimulation (tDCS) combined with aerobic exercise has shown an effect on the modulation of this system. Objective: The Heart Rate Variability (HRV) and the distance traveled on the exercise bike will be assessed to verify the additional impact of tDCS combined with aerobic exercise on individuals with chronic stroke sequelae. Methods: The 34 adult individuals with diagnoses of chronic stroke will be randomized into two aerobic exercise intervention groups: G1 (with active tDCS) and G2 (with sham tDCS), three times a week, for 12 weeks. Procedures: tDCS will be implemented during the aerobic exercise with the anodal electrode positioned over the lateral dorsal prefrontal left cortex, and the cathodal electrode over the contralateral supraorbital region, with 2mA, for 20 minutes. Assessments will be carried out pre, immediately after the intervention, and on the 12th, 24th, 36th interventions, and 30 days later. The HRV data that are pulse interval (PI), square root of the mean of the squares of the differences between adjacent normal RR intervals (rMSSD), absolute high frequency (HF), absolute low frequency (LF), high and low frequency ratio (LF / HF) will be collected using a cardio frequency meter. The analysis of the distance traveled on the exercise bike before and after interventions will be analyzed in meters. Discussion: The autonomic control via brain networks after a stroke can be altered and can promote an increase in sympathetic tone, and a higher risk of sudden death or relapse of stroke. It is crucial to demonstrate the effectiveness of available treatments to improve the autonomic function. Trial registration: The study is registered as a BRAZILIAN CLINICAL TEST RECORD (ReBEC): U1111-1222-4588 on the 2018/10/16

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Transcranial direct current stimulation for children with perinatal stroke and hemiparesis

Neurology ◽

10.1212/wnl.0000000000003518 ◽

2016 ◽

Vol 88 (3) ◽

pp. 259-267 ◽

Cited By ~ 51

Author(s):

Adam Kirton ◽

Patrick Ciechanski ◽

Ephrem Zewdie ◽

John Andersen ◽

Alberto Nettel-Aguirre ◽

...

Keyword(s):

Cerebral Palsy ◽

Motor Learning ◽

Motor Function ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Primary Motor Cortex ◽

Intensive Therapy ◽

Performance Measure ◽

Perinatal Stroke ◽

Direct Current Stimulation

Objective:To determine whether the addition of transcranial direct current stimulation (tDCS) to intensive therapy increases motor function in children with perinatal stroke and hemiparetic cerebral palsy.Methods:This was a randomized, controlled, double-blind clinical trial. Participants were recruited from a population-based cohort with MRI-classified unilateral perinatal stroke, age of 6 to 18 years, and disabling hemiparesis. All completed a goal-directed, peer-supported, 2-week after-school motor learning camp (32 hours of therapy). Participants were randomized 1:1 to 1 mA cathodal tDCS over the contralesional primary motor cortex (M1) for the initial 20 minutes of daily therapy or sham. Primary subjective (Canadian Occupational Performance Measure [COPM]), objective (Assisting Hand Assessment [AHA]), safety, and secondary outcomes were measured at 1 week and 2 months after intervention. Analysis was by intention to treat.Results:Twenty-four participants were randomized (median age 11.8 ± 2.7 years, range 6.7–17.8). COPM performance and satisfaction scores doubled at 1 week with sustained gains at 2 months (p < 0.001). COPM scores increased more with tDCS compared to sham control (p = 0.004). AHA scores demonstrated only mild increases at both time points with no tDCS effects. Procedures were safe and well tolerated with no decrease in either arm function or serious adverse events.Conclusion:tDCS trials appear feasible and safe in hemiparetic children. Lack of change in objective motor function may reflect underdosing of therapy. Marked gains in subjective function with tDCS warrant further study.ClinicalTrials.gov identifier:NCT02170285.Classification of evidence:This study provides Class II evidence that for children with perinatal stroke and hemiparetic cerebral palsy, the addition of tDCS to moderate-dose motor learning therapy does not significantly improve motor function as measured by the AHA.

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