Article

The aim of this article was to determine whether cathodal transcranial
direct current stimulation (c-tDCS) to unaffected primary motor cortex (PMC) plus
conventional occupational therapy (OT) improves functional motor recovery of the
affected arm hand in patients after an acute ischemic stroke compared with sham
transcranial direct current stimulation plus conventional OT. DESIGN: In this
prospective, randomized, double-blinded, sham-controlled trial of 16 severe,
acute ischemic stroke patients with severe arm-hand weakness were randomly
assigned to either experimental (c-tDCS plus OT; n = 8) or control (sham
transcranial direct current stimulation plus OT; n = 8) groups. All patients
received a standard 3-hr in-patient rehabilitation therapy, plus an additional
ten 30-min sessions of tDCS. During each session, 1 mA of cathodal stimulation to
the unaffected PMC is performed followed by the patient's scheduled OT. The
primary outcome measure was change in Action Research Arm Test (ARAT) total and
subscores on discharge. RESULT: Application of c-tDCS to unaffected PMC resulted
in a clinically relevant 10-point improvement in the affected arm-hand function
based on ARAT total score compared with a 2-point improvement in the control
group. CONCLUSIONS: Application of 30-min of c-tDCS to the unaffected PMC showed
a 10-point improvement in the ARAT score. This corresponds to a large effect size
in improvement of affected arm-hand function in patients with severe, acute
ischemic stroke. Although not statistically significant, this suggests that
larger studies, enrolling at least 25 patients in each group, and with a longer
follow-up are warranted.

Langue : ANGLAIS