Article

The question of the best therapeutic window in which
noninvasive brain stimulation (NIBS) could potentiate the plastic changes for
motor recovery after a stroke is still unresolved.
Most of the previous NIBS
studies included patients in the chronic phase of recovery and very few in the
subacute or acute phase.
We investigated the effect of transcranial direct
current stimulation (tDCS) combined with repetitive peripheral nerve stimulation
(rPNS) on the time course of motor recovery in the acute phase after a stroke.
METHODS: Twenty patients enrolled within the first few days after a stroke were
randomized in 2 parallel groups: one receiving 5 consecutive daily sessions of
anodal tDCS over the ipsilesional motor cortex in association with rPNS and the
other receiving the same rPNS combined with sham tDCS. Motor performance (primary
endpoint: Jebsen and Taylor Hand Function Test [JHFT]) and transcranial magnetic
stimulation cortical excitability measures were obtained at baseline (D1), at the
end of the treatment (D5), and at 2 and 4 weeks' follow-up (D15 and D30).
RESULTS: The time course of motor recovery of the 2 groups of patients was
different and positively influenced by the intervention (Group x Time interaction
P = .01). The amount of improvement on the JHFT was greater at D15 and D30 in the
anodal tDCS group than in the sham group. CONCLUSION: These results show that
early cortical neuromodulation with anodal tDCS combined with rPNS can promote
motor hand recovery and that the benefit is still present 1 month after the
stroke.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS