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Cathodal Transcranial Direct Current Stimulation in Acute Ischemic Stroke: Pilot Randomized Controlled Trial
Estelle Pruvost-Robieux1,2,3, Joseph Benzakoun4,2,3, Guillaume Turc5,2,3
1Neurophysiology Department (E.P.-R., A.M., M.G.), GHU Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris.
Stroke
|April 19, 2021
Summary
Cathodal transcranial direct current stimulation (C-tDCS) is a feasible and safe adjunctive therapy for acute stroke patients. While not statistically significant, C-tDCS showed a trend towards reduced infarct growth, particularly in severe stroke cases.
Area of Science:
- Neurology
- Neurosurgery
- Medical Devices
Background:
- Preventing infarct growth is crucial in acute stroke management alongside reperfusion therapies.
- Rodent studies show cathodal transcranial direct current stimulation (C-tDCS) reduces infarct volume.
- C-tDCS offers a non-pharmacological approach to mitigate stroke progression.
Purpose of the Study:
- To evaluate the safety, feasibility, and efficacy of C-tDCS in acute stroke patients undergoing reperfusion therapy.
- To determine if C-tDCS can non-pharmacologically reduce infarct growth in middle cerebral artery territory strokes.
- To assess the impact of C-tDCS on neurological deficit and long-term functional outcome.
Main Methods:
- A pilot, single-center, double-blind, randomized controlled trial (STICA) comparing C-tDCS to sham stimulation.
- 45 patients eligible for recanalization therapies were randomized 1:1.
- Magnetic resonance imaging (MRI) was used to measure infarct growth at 24 hours; clinical outcomes were assessed using NIH Stroke Scale and modified Rankin Scale.
Main Results:
- C-tDCS was feasible and well-tolerated in all patients, with no major adverse effects.
- No statistically significant difference in infarct growth or clinical outcomes was observed between C-tDCS and sham groups.
- A trend towards reduced infarct growth was noted in the C-tDCS arm, particularly in patients with NIH Stroke Scale >10 or large vessel occlusion.
Conclusions:
- C-tDCS is a safe and feasible adjunctive treatment for acute stroke.
- The study suggests potential benefits of C-tDCS in specific patient subgroups, warranting further investigation.
- Future randomized trials should target patients with moderate-to-severe stroke or large vessel occlusion to confirm efficacy.
