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Updated: Feb 24, 2026
Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
Noninvasive Brain Stimulation Improves Hemispatial Neglect After Stroke: A Systematic Review and Meta-Analysis
Ana Paula S Salazar1, Patrícia G Vaz2, Ritchele R Marchese1
1Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
Objective:
To evaluate the effectiveness of noninvasive brain stimulation (NIBS)-repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)-on hemispatial neglect and performance in activities of daily living (ADL) after stroke.
Data Sources:
MEDLINE (PubMed), EMBASE, Cochrane CENTRAL, Scopus, SciELO, and Physiotherapy Evidence Database were searched from database inception to December 2016.
Data Selection:
Randomized controlled trials or crossover trials focused on determining the effects of tDCS or rTMS combined or not combined with other therapies for hemispatial neglect after stroke.
Data Extraction:
Methodological characteristics of the studies, number of participants, comparison groups, interventions, and outcomes were extracted.
Data Synthesis:
Ten trials comprising 226 participants had data that were suitable for the meta-analysis. Meta-analysis showed that NIBS combined with other therapies significantly improves hemispatial neglect (standardized mean difference [SMD]=-1.91; 95% confidence interval [CI], -2.57 to -1.25; I2=71%). A sensitivity analysis showed that rTMS (SMD=-2.16; 95% CI, -3.00 to -1.33; I2=76%) and tDCS (SMD=-1.07; 95% CI, -1.76 to -0.37; I2=0%) had positive effects on hemispatial neglect. Furthermore, both excitatory (SMD=-2.34; 95% CI, -3.56 to -1.12; I2=65%) and inhibitory (SMD=-1.69; 95% CI, -2.49 to -0.88; I2=75%) stimulations were effective.
Conclusions:
This meta-analysis reveals moderate-quality evidence for the effectiveness of NIBS protocols combined with other therapies on hemispatial neglect and performance in ADL after stroke.
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