Transcranial direct current stimulation and suppression of contralesional primary motor cortex post-stroke: a
Nyeonju Kang1,2,3, Amelia Weingart1, James H Cauraugh1
1a Motor Behavior Laboratory, Department of Applied Physiology and Kinesiology , University of Florida , Gainesville , FL , USA.
Objective:
The purpose of this systematic review and meta-analysis was to investigate the therapeutic effects of cathodal tDCS (ctDCS) that suppresses the contralesional primary motor cortex (cM1) activity for individuals with stroke in different recovery phases.
Methods:
Fifteen studies that used ctDCS for suppressing the cM1 activity were included in this meta-analysis. Twenty total comparisons from the qualified studies identified motor function changes between ctDCS and sham protocols. We divided recovery stages into two categories: (a) acute and subacute phases (time since stroke ≤6 months): eight comparisons and (b) chronic phase (time since stroke >6 months): 12 comparisons.
Results:
Random-effects meta-analysis models revealed motor improvements after applying ctDCS on the cM1 as indicated by a significant standardized effect size (ES = 0.61; P < 0.001). The moderator variable analysis showed that acute and subacute patients revealed no significant effect size of ctDCS (ES = 0.46; P = 0.07), whereas the ctDCS protocol significantly improved motor functions in chronic patients (ES = 0.71; P < 0.001).
Conclusion:
This comprehensive meta-analysis indicates that the treatment effects of ctDCS on the cM1 are different between patients in the acute and subacute phases and patients in the chronic phase post-stroke.
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