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Effects of a single session of transcranial direct current stimulation on upper limb movements in children with
Renata Calhes Franco Moura1, Cibele Santos1, Luanda Collange Grecco1
1a Departmente Postgraduate , Universidade Nove de Julho , Sao Paulo , Brazil.
Insights
A single session of anodal transcranial direct current stimulation (tDCS) improved upper limb movement in children with spastic hemiparetic cerebral palsy (CP). This intervention led to faster movements, offering momentary motor gains for both affected and unaffected limbs.
Area of Science:
- Neuroscience
- Pediatric Rehabilitation
- Motor Control Research
Background:
- Children with spastic hemiparetic cerebral palsy (CP) experience significant upper limb motor impairments.
- These impairments include difficulties with coordination, selective motor control, weakness, and sensory-motor integration, limiting hand function.
Purpose of the Study:
- To investigate the immediate effects of anodal transcranial direct current stimulation (tDCS) combined with functional training on upper arm movement spatiotemporal variables.
- To assess these effects in children diagnosed with spastic hemiparesis.
Main Methods:
- A randomized, sham-controlled trial involving 20 children (6-12 years) with CP.
- Participants received a 20-minute functional training session with either active anodal tDCS or sham tDCS over the primary motor cortex.
- Spatiotemporal upper limb variables were evaluated immediately before and after the intervention.
Main Results:
- The active tDCS group showed statistically significant reductions in total movement duration and returning movement duration for both paretic and non-paretic upper limbs.
- No significant changes in these variables were observed in the sham tDCS (control) group.
Conclusions:
- A single session of anodal tDCS applied to the primary motor cortex can yield immediate, albeit temporary, improvements in upper limb motor function.
- These findings suggest tDCS as a potential adjunct therapy for enhancing motor control in pediatric CP.
Introduction:
Motor impairment in children with spastic hemiparetic cerebral palsy (CP) is generally more prominent in the affected upper limb, leading to limitations in hand function stemming from deficiencies in motor coordination and selective motor control as well as muscle weakness, slower execution of movements and deficient integration of sensory-motor information.
Objective:
Determine the effect of a single session of anodal transcranial direct current stimulation (tDCS) combined with functional training on the spatiotemporal variables of upper arm movements in children with spastic hemiparesis.
Method:
A randomized, sham-controlled trial with a blinded evaluator was conducted involving 20 children with CP between 6 and 12 years of age. The spatiotemporal variables of the upper limbs were analyzed by comparing the results of Evaluation 1 (before stimulation) and Evaluation 2 (immediately after stimulation). The protocol consisted of a 20-minute session of functional training of the paretic upper limb combined with tDCS administered over the primary motor cortex of the hemisphere contralateral to the motor impairment at an intensity of 1 mA. The participants were randomly allocated to two groups: experimental group (anodal tDCS) and control group (sham tDCS).
Results:
Statistically significant (p < 0.05) reductions in total movement duration and returning movement duration were found in both the paretic and non-paretic limbs in the group submitted to active tDCS. No significant differences were found in the control group for any of the variables analyzed.
Conclusion:
A single session of anodal tDCS over the primary motor cortex of the hemisphere ipsilateral to the brain lesion led to momentary motor improvements in both upper limbs of the children with spastic hemiparetic CP analyzed in the present study.
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