Article

Transcranial direct current stimulation (tDCS) has been proposed as a tool to
enhance stroke rehabilitation; however, evidence to support its use is lacking.
The aim of this study was to investigate the effects of anodal and cathodal tDCS
on upper limb function in chronic stroke patients. Twenty five participants were
allocated to receive 20 min of 1 mA of anodal, cathodal or sham cortical
stimulation in a random, counterbalanced order.
Patients and assessors were
blinded to the intervention at each time point. The primary outcome was upper
limb performance as measured by the Jebsen Taylor Test of Hand Function (total
score, fine motor subtest score and gross motor subtest score) as well as grip
strength. Each outcome was assessed at baseline and at the conclusion of each
intervention in both upper limbs. Neither anodal nor cathodal stimulation
resulted in statistically significantly improved upper limb performance on any of
the measured tasks compared with sham stimulation (P>0.05). When the data were
analysed according to disability, participants with moderate/severe disability
showed significantly improved gross motor function following cathodal stimulation
compared with sham (P=0.014). However, this was accompanied by decreased key grip
strength in the unaffected hand (P=0.003). We are unable to endorse the use of
anodal and cathodal tDCS in the management of upper limb dysfunction in chronic
stroke patients. Although there appears to be more potential for the use of
cathodal stimulation in patients with severe disability, the effects were small
and must be considered with caution as they were accompanied by unanticipated
effects in the unaffected upper limb.

Langue : ANGLAIS