Related Experiment Video
Updated: Nov 17, 2025
Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
Effect of transcranial direct current stimulation on post-stroke fatigue
William De Doncker1, Sasha Ondobaka2,3, Annapoorna Kuppuswamy2
1Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, WC1N 3BG, United Kingdom. William.doncker.11@ucl.ac.uk.
Background:
Fatigue is one of the most commonly reported symptoms post-stroke, which has a severe impact on the quality of life. Post-stroke fatigue is associated with reduced motor cortical excitability, specifically of the affected hemisphere.
Objective:
The aim of this exploratory study was to assess whether fatigue symptoms can be reduced by increasing cortical excitability using anodal transcranial direct current stimulation (tDCS).
Methods:
In this sham-controlled, double-blind intervention study, tDCS was applied bilaterally over the primary motor cortex in a single session in thirty stroke survivors with high severity of fatigue. A questionnaire-based measure of trait fatigue (primary outcome) was obtained before, after a week and 5 weeks post stimulation. Secondary outcome measures of state fatigue, motor cortex neurophysiology and perceived effort were also assessed pre, immediately post, a week and 5 weeks post stimulation.
Results:
Anodal tDCS significantly improved fatigue symptoms a week after real stimulation when compared to sham stimulation. There was also a significant change in motor cortex neurophysiology of the affected hemisphere and perceived effort, a week after stimulation. The degree of improvement in fatigue was associated with baseline anxiety levels.
Conclusion:
A single session of anodal tDCS improves fatigue symptoms with the effect lasting up to a week post stimulation. tDCS may therefore be a useful tool for managing fatigue symptoms post-stroke.
Trial Registration:
NCT04634864 DATE OF REGISTRATION: 17/11/2020-"retrospectively registered".
