Enhancement of Cortical Excitability and Lower Limb Motor Function in Patients With Stroke by Transcranial Direct Current Stimulation

Lee, Hee Jin; Kim, Dae Yul; Park, Dae Hwan

doi:10.1016/j.brs.2015.01.411

Cited by 110 publications

(125 citation statements)

References 36 publications

(23 reference statements)

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“…The age range ranged from 34 to 84. Most subjects have chronic stroke, only one study includes only subacute subjects (7-30 days from the event) [16], and another study included both [15]. Bilateral stimulation was administered in majority of trails, while in 2 studies anodal stimulation was investigated [16] and cathodal stimulation in one study [18]; The current intensity varies from 1 mA to 2 mA.…”

Section: Resultsmentioning

confidence: 99%

“…Most subjects have chronic stroke, only one study includes only subacute subjects (7-30 days from the event) [16], and another study included both [15]. Bilateral stimulation was administered in majority of trails, while in 2 studies anodal stimulation was investigated [16] and cathodal stimulation in one study [18]; The current intensity varies from 1 mA to 2 mA. In most studies the hemisphere affected by the anode electrode and the cathode electrode positioned on the hemisphere has been stimulated; only 3 studies have used monocephalic montage [6,16,18].…”

Section: Resultsmentioning

confidence: 99%

“…In most cases the evaluation is inherent to the upper limb, in a trial the first measure was the response to the treatment of the lower limb [16] and in one studies the effects on visual perception [13]. In the assessment of dependency, the analysis for comparison of active vs. sham treatment showed, as in Figure 2A, a statistically significant reduction (p=0.02) of the dependency rate after tDCS treatment, with a standardized score difference of 0.51 (95% CI 0.07-0.94), without significant heterogeneity among studies (p=0.39).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies involving eight used a bilateral montage, including the anodal stimulation of M1 of the ipsilesional hemisphere (C3 and C4 EEG 10/20 system), cathodal stimulation of M1 of the controlesional hemisphere or cathodal stimulation of the contralateral supraorbital area to the lesion [12][13][14][15][16][17][18][19]. Bilateral montage is often used based on the assumption that the movements of the impaired limbs are often associated with a high level of transcallosal inhibition by the hemisphere not affected by the hemisphere being injured [10,20]; some studies conducted with multimodal imaging techniques and mapping, such as fMRIs and TMSs, confirmed the existence of this imbalance of the hemisphere not affected, also called a hemispheric competition model, particularly during the preparation and execution of upperlimb motor acts [21,22], some authors hypothesize that the amount of this imbalance in inter-hemispheric excitability may be positively correlated with the degree of severity of motor disability [10,6].…”

Section: Discussionmentioning

confidence: 99%

“…Eight studies were considered for a total of 178 subjects included [6,[12][13][14][15][16][17][18]. Computer literacy research has been focused on post-stroke motor recovery studies by administering non-invasive brain stimulation (NIBS) including transcranial direct current stimulation (tDCS); the research period of the literature is between January 2005 and May 2016.…”

Section: Literature Research and Selection Of Studiesmentioning

confidence: 99%

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Efficacy of Transcranial Direct Current Stimulation as Support for Neurorehabilitation Therapy: A Meta-analysis of Available Studies

Pa¹,

Marini²

2017

Int J Phys Med Rehabil

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Transcranial direct current stimulation (tDCS) is a non-invasive, well-tolerated, brain stimulation technique, using a weak current applied on the scalp. Rational of tDCS use has been based on the assumption of the post-stroke inter-hemispheric competition model, resulting in a hypo-excitability hemispheric lesion and a hyper-excitability healthy hemisphere, to improve the recovery of motor function. Several small studies have been published but the efficacy of tDCS is not established. We performed a systematic review of published studies to assess efficacy of tDCS on motor function of patients with stroke. A thorough search of main databases has been performed to identify randomized, controlled studies on efficacy of tDCS in patients with stroke. The values derived from the primary outcome measures of these studies have been standardized to make them comparable; eight comparisons were planned: degree of dependence, improvement of upper limb, improvement of global motor function, improvement of lower limb and visual perception; comparison between anode stimulation and sham, anode stimulation and followup. 8 studies have been included in the meta-analysis. 3 studies have been excluded because of lack of statistical data, non-randomized assignment and lack of a control group; 178 participants have been included altogether. Most of comparisons did not produce significant results; however a significant improvement of dependence scores (p=0.02), of lower limb index (p=0.02), and of visual perception (p=0.02) have been found. Despite the encouraging results by neurophysiological and instrumental investigations, in some heterogeneous cases, our study shows that there is a need to conduct studies with larger sample sizes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Literature Research and Selection Of Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy of Transcranial Direct Current Stimulation as Support for Neurorehabilitation Therapy: A Meta-analysis of Available Studies

Pa¹,

Marini²

2017

Int J Phys Med Rehabil

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Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke

Elsner

Kügler

Pohl

et al. 2020

Cochrane Database of Systematic Reviews

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Associative cued asynchronous BCI induces cortical plasticity in stroke patients

Niazi

Navid

Rashid

et al. 2022

Ann Clin Transl Neurol

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Objective We propose a novel cue‐based asynchronous brain–computer interface(BCI) for neuromodulation via the pairing of endogenous motor cortical activity with the activation of somatosensory pathways. Methods The proposed BCI detects the intention to move from single‐trial EEG signals in real time, but, contrary to classic asynchronous‐BCI systems, the detection occurs only during time intervals when the patient is cued to move. This cue‐based asynchronous‐BCI was compared with two traditional BCI modes (asynchronous‐BCI and offline synchronous‐BCI) and a control intervention in chronic stroke patients. The patients performed ankle dorsiflexion movements of the paretic limb in each intervention while their brain signals were recorded. BCI interventions decoded the movement attempt and activated afferent pathways via electrical stimulation. Corticomotor excitability was assessed using motor‐evoked potentials in the tibialis‐anterior muscle induced by transcranial magnetic stimulation before, immediately after, and 30 min after the intervention. Results The proposed cue‐based asynchronous‐BCI had significantly fewer false positives/min and false positives/true positives (%) as compared to the previously developed asynchronous‐BCI. Linear‐mixed‐models showed that motor‐evoked potential amplitudes increased following all BCI modes immediately after the intervention compared to the control condition (p <0.05). The proposed cue‐based asynchronous‐BCI resulted in the largest relative increase in peak‐to‐peak motor‐evoked potential amplitudes(141% ± 33%) among all interventions and sustained it for 30 min(111% ± 33%). Interpretation These findings prove the high performance of a newly proposed cue‐based asynchronous‐BCI intervention. In this paradigm, individuals receive precise instructions (cue) to promote engagement, while the timing of brain activity is accurately detected to establish a precise association with the delivery of sensory input for plasticity induction.

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Enhancement of Cortical Excitability and Lower Limb Motor Function in Patients With Stroke by Transcranial Direct Current Stimulation

Cited by 110 publications

References 36 publications

Efficacy of Transcranial Direct Current Stimulation as Support for Neurorehabilitation Therapy: A Meta-analysis of Available Studies

Efficacy of Transcranial Direct Current Stimulation as Support for Neurorehabilitation Therapy: A Meta-analysis of Available Studies

Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke

Associative cued asynchronous BCI induces cortical plasticity in stroke patients

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