Related Experiment Video
Updated: Dec 4, 2025
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Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
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Combining transcranial direct current stimulation with aerobic exercise to optimize cortical priming in stroke
Anjali Sivaramakrishnan1,2, Sangeetha Madhavan1
1Brain Plasticity Lab, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (UIC), Chicago, IL 60612, USA.
Summary
Combining aerobic exercise and transcranial direct current stimulation (tDCS) in stroke survivors upregulated motor cortex excitability compared to exercise alone. However, this combination did not enhance motor control or inhibition beyond tDCS alone.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Motor Control
Background:
- Aerobic exercise (AE) and transcranial direct current stimulation (tDCS) are known neuromodulatory techniques.
- Their combined effects on corticomotor excitability (CME) in stroke survivors remain unexplored.
Purpose of the Study:
- To investigate the synergistic effects of AE and tDCS on CME, inhibition, and motor control in the lower limb of stroke survivors.
- To compare the effects of tDCS alone, AE alone, and the combination of AE+tDCS.
Main Methods:
- Twenty-six stroke survivors underwent three sessions: tDCS, AE, and AE+tDCS.
- AE involved moderate-intensity exercise; tDCS used 1 mA anodal stimulation on the lower limb motor cortex.
- Outcomes measured CME, short-interval intracortical inhibition (SICI), ipsilateral silent period (iSP), and ankle reaction time.
Main Results:
- Ipsilesional CME significantly decreased with AE compared to AE+tDCS and tDCS alone.
- No significant differences were found in SICI, iSP, or reaction time across the three conditions.
- The AE+tDCS and tDCS sessions showed greater ipsilesional hemisphere excitability than AE alone.
Conclusions:
- The combination of AE and tDCS, and tDCS alone, upregulate descending motor pathways from the ipsilesional primary motor cortex compared to AE alone.
- No additive benefits of combining AE and tDCS were observed over tDCS alone for motor control or inhibition.
- These findings highlight the specific effects of AE+tDCS on corticomotor pathways in stroke rehabilitation.
