Related Experiment Video
Updated: Mar 10, 2026
Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
Transcranial direct current stimulation for children with perinatal stroke and hemiparesis
Adam Kirton1, Patrick Ciechanski2, Ephrem Zewdie2
1From the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; Department of Neurosciences (P.C.) and Hotchkiss Brain Institute (A.K., M.H.), Cumming School of Medicine, University of Calgary; Calgary Pediatric Stroke Program (A.K., P.C., E.Z., H.C., A.M., J.H.) and Department of Pediatrics (A.N.-A.), Alberta Children's Hospital; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; and Clinical Neurosciences (L.C., M.H., J.Q.), Alberta Children's Hospital, Alberta Health Services, Calgary, Canada. adam.kirton@albertahealthservices.ca.
Insights
This study found that transcranial direct current stimulation (tDCS) added to intensive therapy improved subjective motor function in children with perinatal stroke and hemiparetic cerebral palsy, but did not significantly improve objective measures.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Neuroscience
Background:
- Children with perinatal stroke often experience hemiparetic cerebral palsy, impacting motor function.
- Intensive therapy is a cornerstone for improving motor outcomes in this population.
- The potential of non-invasive brain stimulation, like tDCS, to augment therapy benefits is an area of active research.
Purpose of the Study:
- To investigate if adding transcranial direct current stimulation (tDCS) to intensive therapy enhances motor function in children with hemiparetic cerebral palsy due to perinatal stroke.
- To evaluate both subjective and objective measures of motor function improvement.
Main Methods:
- A randomized, controlled, double-blind clinical trial involving children aged 6 to 18 years with unilateral perinatal stroke and hemiparesis.
- Participants underwent a 2-week intensive motor learning camp.
- Intervention groups received either active 1 mA cathodal tDCS over the contralesional primary motor cortex or sham stimulation.
- Outcomes including the Canadian Occupational Performance Measure (COPM) and Assisting Hand Assessment (AHA) were assessed.
Main Results:
- Both groups showed significant improvements in subjective motor function (COPM scores) from baseline, with greater gains in the tDCS group.
- Objective motor function (AHA scores) showed only minor improvements, with no significant difference between tDCS and sham groups.
- The intervention was safe and well-tolerated, with no adverse events reported.
Conclusions:
- Transcranial direct current stimulation (tDCS) appears feasible and safe for children with hemiparetic cerebral palsy.
- While tDCS showed promise in improving subjective functional gains, it did not significantly enhance objective motor function as measured by the AHA.
- Further research is warranted to explore optimal tDCS parameters and its role in pediatric neurorehabilitation.
Objective:
To determine whether the addition of transcranial direct current stimulation (tDCS) to intensive therapy increases motor function in children with perinatal stroke and hemiparetic cerebral palsy.
Methods:
This was a randomized, controlled, double-blind clinical trial. Participants were recruited from a population-based cohort with MRI-classified unilateral perinatal stroke, age of 6 to 18 years, and disabling hemiparesis. All completed a goal-directed, peer-supported, 2-week after-school motor learning camp (32 hours of therapy). Participants were randomized 1:1 to 1 mA cathodal tDCS over the contralesional primary motor cortex (M1) for the initial 20 minutes of daily therapy or sham. Primary subjective (Canadian Occupational Performance Measure [COPM]), objective (Assisting Hand Assessment [AHA]), safety, and secondary outcomes were measured at 1 week and 2 months after intervention. Analysis was by intention to treat.
Results:
Twenty-four participants were randomized (median age 11.8 ± 2.7 years, range 6.7-17.8). COPM performance and satisfaction scores doubled at 1 week with sustained gains at 2 months (p < 0.001). COPM scores increased more with tDCS compared to sham control (p = 0.004). AHA scores demonstrated only mild increases at both time points with no tDCS effects. Procedures were safe and well tolerated with no decrease in either arm function or serious adverse events.
Conclusion:
tDCS trials appear feasible and safe in hemiparetic children. Lack of change in objective motor function may reflect underdosing of therapy. Marked gains in subjective function with tDCS warrant further study.
Clinicaltrialsgov Identifier:
NCT02170285.
Classification Of Evidence:
This study provides Class II evidence that for children with perinatal stroke and hemiparetic cerebral palsy, the addition of tDCS to moderate-dose motor learning therapy does not significantly improve motor function as measured by the AHA.
