Abstract P200: Transcranial Direct Current Stimulation in Post-Stroke Chronic Aphasia: A Double Blind Randomized Controlled Study

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Caroline Schnakers ◽  
Zhong Sheng Zheng ◽  
Henry Millan ◽  
Sharon Lee ◽  
Melissa Howard ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Superior Cerebellar Peduncle ◽  
Double Blind ◽  
Verbal Comprehension ◽  
Direct Current Stimulation ◽  
Post Stroke ◽  
Chronic Aphasia ◽  
Cerebellar Peduncle

Background: There is growing evidence even amongst those with chronic aphasia that transcranial direct current stimulation (tDCS) combined with behavioral speech therapy could boost language. However, current findings do not allow making strong recommendations for using tDCS in order to improve language in post-stroke aphasia. The efficacy of tDCS therefore still needs to be established using double-blind controlled randomized trials in large samples. Intervention: In this ongoing double-blind randomized placebo controlled trial study, participants were randomly assigned either to the tDCS group or to the sham group. Both groups had five consecutive days of 20 minutes session, using a FDA approved tDCS device (soterixmedical.com). Behavioral and neuroimaging data were performed the week before/after tDCS/sham intervention and again 3 months following treatment. Participants: 42 post-stroke patients with chronic aphasia (32 males; age: 61±11y; 0.9-18years post-injury; 32 ischemic stroke; 19 non-fluent aphasia). Eighteen patients were in the tDCS group. Main Outcome Measures: The Western Aphasia Battery-Revised (WAB-R), Communication Outcomes after Stroke, patient and family report (COAST). MRI Diffusion Tensor Imaging data (64 dir) were also collected. Statistical Analyses: Anova with repeated measures was used on the behavioral outcome measures with aphasia severity, age and time since injury as covariates in SPSS. The average fractional anisotropy (FA) and mean diffusivity (MD) were extracted per ROI from each participant and timepoint. Main Results: a) Behavioral. Groups differed, pre/post intervention, on the WAB-R total score, for the Auditory-Verbal Comprehension and Repetition subscores; b) Neuroimaging. Change in Spontaneous Speech and Auditory Verbal Comprehension negatively correlated with change in mean MD and FA, respectively, in Superior Cerebellar Peduncle for tDCS, but not sham. Conclusion: Our preliminary findings show a higher improvement in language functions (for both receptive and expressive language skills) in response to treatment (vs. sham). Neuroplasticity was observed in superior cerebellar peduncle in response to tDCS mediated language improvement.

scholarly journals Transcranial Direct Current Stimulation and Mirror Therapy for Neuropathic Pain After Brachial Plexus Avulsion: A Randomized, Double-Blind, Controlled Pilot Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Clarice Martins Ferreira ◽  
Carolina Dias de Carvalho ◽  
Ruth Gomes ◽  
Erickson Duarte Bonifácio de Assis ◽  
Suellen Marinho Andrade
Keyword(s):  
Neuropathic Pain ◽  
Pain Relief ◽  
Brachial Plexus ◽  
Outcome Measures ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Mirror Therapy ◽  
Double Blind ◽  
Direct Current Stimulation

Introduction: Although transcranial direct current stimulation (tDCS) and mirror therapy (MT) have benefits in combating chronic pain, there is still no evidence of the effects of the simultaneous application of these techniques in patients with neuropathic pain. This study aims to assess the efficacy of tDCS paired with MT in neuropathic pain after brachial plexus injury.Methods: In a sham controlled, double-blind, parallel-group design, 16 patients were randomized to receive active or sham tDCS administered during mirror therapy. Each patient received 12 treatment sessions, 30 min each, during a period of 4 weeks over M1 contralateral to the side of the injury. Outcome variables were evaluated at baseline and post-treatment using the McGill questionnaire, Brief Pain Inventory, and Medical Outcomes Study 36–Item Short-Form Health Survey. Long-term effects of treatment were evaluated at a 3-month follow-up.Results: An improvement in pain relief and quality of life were observed in both groups (p ≤ 0.05). However, active tDCS and mirror therapy resulted in greater improvements after the endpoint (p ≤ 0.02). No statistically significant differences in the outcome measures were identified among the groups at follow-up (p ≥ 0.12). A significant relationship was found between baseline pain intensity and outcome measures (p ≤ 0.04). Moreover, the results showed that state anxiety is closely linked to post-treatment pain relief (p ≤ 0.05).Conclusion: Active tDCS combined with mirror therapy has a short-term effect of pain relief, however, levels of pain and anxiety at the baseline should be considered.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT04385030.

scholarly journals Effects of transcranial direct current stimulation on patients with post stroke fatigue: A study protocol for a double-blind randomized controlled trial

2021 ◽  
Author(s):  
Weiming Sun ◽  
Xing Sun ◽  
Xiangli Dong ◽  
Guohua Yu ◽  
Lang Shuai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Controlled Trial ◽  
Double Blind ◽  
Direct Current Stimulation ◽  
Post Stroke ◽  
Randomized Controlled

Abstract Introduction Post stroke fatigue (PSF) is an abnormal, persistent, and unexplained physical and psychological tiredness in patients after stroke. It is a common symptom of stroke patients with poor quality of life and bleak prognosis, and the incidence rate is up to 39–72%. It has been widely reported that medicine treatments achieved a lot of progress, there still needs to develop more powerful new strategies to more powerful effect. The transcranial direct-current stimulation (tDCS) shows great potential for the treatment of PSF. This study proposes to apply a double-blind randomized controlled clinical trial to explore the effect and safety of tDCS combined with routine rehabilitation for PSF. Methods and analysis One hundred patients with PSF will be randomly divided into two groups. One of the groups will receive conventional rehabilitation therapy and active tDCS, whereas another group will receive conventional rehabilitation treatment and sham tDCS. Both groups will receive the intervention for 4 weeks, during which time they will undergo either active or sham tDCS 20 minutes a day, 6 days a week. Primary outcome: Fatigue Severity Scale (FSS) will be measured at baseline every weekend during the intervention period. Secondary results: Fatigue Impact Scale (FIS), Functional Assessment Chronic Illness Therapy (Fatigue) (FACIT-F), Specialized Quality of Life Scale in Stroke (SS-QOL) will be measured at baseline and at the end of the intervention time of 4 weeks. Throughout the study, adverse events and adverse reactions will be measured during every treatment. The research study”Effects of transcranial direct current stimulation on patients with post stroke fatigue” has been approved by the Ethics Committee of the First Affiliated Hospital of Nanchang University: Clinical Medicine Ethics Review [2015]043 in Nov, 2015. Discussion This study will provide insight on the efficacy of transcranial direct-current stimulation for post stroke fatigue. This is a double-blind randomized controlled trial whose aim is to assess the effects of tDCS on PSF.This study can provide more information about the treatment of PSF. This study has a period of follow-up, which allows for greater accuracy. It is a single-center trial and this may be a limitation. The other limitation of this study is a relatively small number of participants; thus, the influence of chance on experimental results cannot be completely ruled out. Trial registration number Chinese Clinical Trial Registry,ChiCTR2000031120. Registered on March 22, 2020. This protocol version number is V1.1.

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