The comparative effects of unilateral and bilateral transcranial direct current stimulation on motor learning and motor performance: A systematic review of literature and meta-analysis

Halakoo, Sara; Ehsani, Fatemeh; Hosnian, Motahareh; Zoghi, Maryam; Jaberzadeh, Shapour

doi:10.1016/j.jocn.2019.12.022

Cited by 32 publications

(26 citation statements)

References 29 publications

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“…The main aim of the present work was to explore bi-RP-tDCS application effects over motor learning, combined with a five-day training program. The hypotheses supported that the application of bi-RP-tDCS does not improve motor learning as other application modes like anodal or bi-hemispheric tDCS do when used following similar parameters [ 14 , 28 , 29 , 30 , 31 , 32 ]. These results provide information on the direction of an interhemispheric competition model [ 33 ].…”

Section: Discussionmentioning

confidence: 86%

“…On the other hand, cathodal tDCS over the ipsilateral M1 seems to facilitate motor learning [ 14 , 26 ], probably due to the interhemispheric inhibition phenomenon found in the human motor cortex [ 27 ]. Then, searching new and more efficient tDCS protocols, bi-hemispheric tDCS application (anode on contralateral M1 and cathode on ipsilateral M1, bi-tDCS, Figure 1 c) was proposed, seeming to have greater effects than unilateral a-tDCS stimulation in healthy subjects [ 14 , 28 , 29 , 30 , 31 , 32 ]. The reasoning for this tDCS application is guided by an interhemispheric competition model, in which both hemispheres suppress each other through inhibitory connections [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

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Reversed Polarity bi-tDCS over M1 during a Five Days Motor Task Training Did Not Influence Motor Learning. A Triple-Blind Clinical Trial

et al. 2021

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Transcranial direct current stimulation (tDCS) has been investigated as a way of improving motor learning. Our purpose was to explore the reversal bilateral tDCS effects on manual dexterity training, during five days, with the retention component measured after 5 days to determine whether somatosensory effects were produced. In this randomized, triple-blind clinical trial, 28 healthy subjects (14 women) were recruited and randomized into tDCS and placebo groups, although only 23 participants (13 women) finished the complete protocol. Participants received the real or placebo treatment during five consecutive days, while performing a motor dexterity training program of 20 min. The motor dexterity and the sensitivity of the hand were assessed pre- and post-day 1, post 5 days of training, and 5 days after training concluded. Training improved motor dexterity, but tDCS only produced a tendency to improve retention. The intervention did not produce changes in the somatosensory variables assessed. Thus, reversal bi-tDCS had no effects during motor learning on healthy subjects, but it could favor the retention of the motor skills acquired. These results do not support the cooperative inter-hemispheric model.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Reversed Polarity bi-tDCS over M1 during a Five Days Motor Task Training Did Not Influence Motor Learning. A Triple-Blind Clinical Trial

et al. 2021

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“…This suggested that bilateral stimulation might be better than unilateral stimulation in improving balance and gait. Prior studies have found that bilateral tDCS stimulation was better than unilateral tDCS in regulating motor excitability ( 45 ), and bilateral tDCS could better reduce stroke patients' fall risk than unilateral tDCS ( 46 ). However, further studies are still needed to explore the detailed mechanism of bilateral tDCS in the rehabilitation of balance following stroke.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Transcranial Direct Current Stimulation on Balance and Gait in Stroke Patients: A Systematic Review and Meta-Analysis

et al. 2021

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Objective: Balance dysfunction after stroke often results in individuals unable to maintain normal posture, limits the recovery of gait and functional independence. We explore the short-term effects of transcranial direct current stimulation (tDCS) on improving balance function and gait in stroke patients.Methods: We systematically searched on PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar for studies that explored the effects of tDCS on balance after stroke until August 2020. All involved studies used at least one measurement of balance, gait, or postural control as the outcome.Results: A total of 145 studies were found, of which 10 (n = 246) met the inclusion criteria and included in our studies. The present meta-analysis showed that active tDCS have beneficial effects on timed up and go test (TUGT) [mean difference (MD): 0.35; 95% confidence interval (CI): 0.11 to 0.58] and Functional Ambulation Category (FAC) (MD: −2.54; 95% CI: −3.93 to −1.15) in stroke patients. However, the results were not significant on the berg balance scale (BBS) (MD: −0.20; 95% CI: −1.44 to 1.04), lower extremity subscale of Fugl-Meyer Assessment (FMA-LE) (MD: −0.43; 95% CI: −1.70 to 0.84), 10-m walk test (10 MWT) (MD: −0.93; 95% CI: −2.68 to 0.82) and 6-min walking test (6 MWT) (MD: −2.55; 95% CI: −18.34 to 13.23).Conclusions: In conclusion, we revealed that tDCS might be an effective option for restoring walking independence and functional ambulation for stroke patients in our systematic review and meta-analysis.Systematic Review Registration: CRD42020207565.

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“…Anodal tDCS has been assumed to augment neuronal excitability while cathodal tDCS would diminish it (Nitsche et al., 2003; Nitsche & Paulus, 2000). With regard to motor function, it has been suggested that bilateral tDCS, with the anode over the nondominant motor cortex and the cathode over the dominant motor cortex, may yield stronger effects on motor learning as compared to unilateral stimulation (Halakoo et al., 2020; Vines et al., 2008). As a consequence, there is a particular interest to use bilateral stimulation as an adjuvant therapy during physical rehabilitation of stroke patients with motor deficits (Di Lazzaro et al., 2014; Di Pino et al., 2014).…”

Section: Introductionmentioning

confidence: 99%

Activation response and functional connectivity change in rat cortex after bilateral transcranial direct current stimulation—An exploratory study

Boonzaier

Straathof

Ardesch

et al. 2021

J of Neuroscience Research

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Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique implicated as a promising adjunct therapy to improve motor function through the neuromodulation of brain networks. Particularly bilateral tDCS, which affects both hemispheres, may yield stronger effects on motor learning than unilateral stimulation. Therefore, the aim of this exploratory study was to develop an experimental model for simultaneous magnetic resonance imaging (MRI) and bilateral tDCS in rats, to measure instant and resultant effects of tDCS on network activity and connectivity. Naïve, male Sprague-Dawley rats were divided into a tDCS (n = 7) and sham stimulation group (n = 6). Functional MRI data were collected during concurrent bilateral tDCS over the sensorimotor cortex, while resting-state functional MRI and perfusion MRI were acquired directly before and after stimulation. Bilateral tDCS induced a hemodynamic activation response, reflected by a bilateral increase in blood oxygenation level-dependent signal in different cortical areas, including the sensorimotor regions. Resting-state functional connectivity within the cortical sensorimotor network decreased after a first stimulation session but increased after a second session, suggesting an interaction between multiple tDCS sessions. Perfusion MRI revealed no significant changes in cerebral blood flow after tDCS. Our exploratory study demonstrates successful application of an MRI-compatible bilateral tDCS setup in an animal model. Our results indicate that bilateral tDCS can locally modulate neuronal activity and connectivity, which may underlie its therapeutic potential.

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The comparative effects of unilateral and bilateral transcranial direct current stimulation on motor learning and motor performance: A systematic review of literature and meta-analysis

Cited by 32 publications

References 29 publications

Reversed Polarity bi-tDCS over M1 during a Five Days Motor Task Training Did Not Influence Motor Learning. A Triple-Blind Clinical Trial

Reversed Polarity bi-tDCS over M1 during a Five Days Motor Task Training Did Not Influence Motor Learning. A Triple-Blind Clinical Trial

The Effects of Transcranial Direct Current Stimulation on Balance and Gait in Stroke Patients: A Systematic Review and Meta-Analysis

Activation response and functional connectivity change in rat cortex after bilateral transcranial direct current stimulation—An exploratory study

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