Transcranial electrostimulation with special waveforms enhances upper-limb motor function in patients with chronic...

Area of Science:

• Neuroscience and Rehabilitation
• Clinical Neurophysiology
• Neurology

Background:

• Transcranial direct current stimulation (tDCS) and intermittent theta burst stimulation (iTBS) show therapeutic potential for neuroplasticity in rehabilitation.
• A novel device combining tDCS and iTBS waveforms was developed, but its clinical effects require further investigation.
• This study addresses the limited research on the combined tDCS-iTBS waveform's efficacy in clinical rehabilitation.

Purpose of the Study:

• To investigate the brain stimulation effects of combined tDCS-iTBS on upper-limb motor function in chronic stroke patients.
• To evaluate the therapeutic potential of a novel non-invasive brain stimulation (NIBS) device in stroke rehabilitation.

Main Methods:

• Twenty-four chronic stroke patients were randomized into real non-invasive brain stimulation (NIBS; tDCS+iTBS) or sham NIBS groups.
• Participants received 18 sessions (1 hour each, 3 times/week for 6 weeks) of conventional rehabilitation with simultaneous 20-minute NIBS.
• Outcome measures included Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Jebsen-Taylor Hand Function Test (JTT), and Finger-to-Nose Test (FNT), assessed pre- and post-intervention.

Main Results:

• Both real and sham NIBS groups showed improvements in FMA-UE, JTT, and FNT scores post-intervention.
• The real NIBS group demonstrated significantly greater improvements in JTT (p=0.016) and FNT (p=0.037) scores compared to the sham group.
• Statistical analysis used the Mann-Whitney rank-sum test to compare group differences.

Conclusions:

• Combined ipsilesional tDCS-iTBS with conventional rehabilitation led to significantly greater improvements in JTT and FNT compared to sham stimulation in stroke patients.
• The findings suggest that tDCS-iTBS combined with conventional rehabilitation is a promising strategy for enhancing upper-limb functional recovery post-stroke.
• This novel NIBS approach may offer enhanced therapeutic benefits in future clinical rehabilitation settings.