Related Experiment Video
Updated: Oct 23, 2025
08:53
Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
873
Contralesional Cathodal Transcranial Direct Current Stimulation Does Not Enhance Upper Limb Function in Subacute
Danielle De S Boasquevisque1,2, Larissa Servinsckins1, Joselisa P Q de Paiva1
1Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil.
Neural Plasticity
|August 24, 2021
Summary
Active cathodal transcranial direct current stimulation (tDCS) of the unaffected hemisphere did not improve upper limb motor recovery in early stroke patients. The sham group showed greater improvements in motor function, cognition, and daily activities compared to the active tDCS group.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Stroke Recovery
Background:
- Excessive interhemispheric inhibition from the unaffected to the affected motor cortex may impede motor recovery after stroke.
- Transcranial direct current stimulation (tDCS) is explored as a method to modulate cortical excitability and enhance stroke rehabilitation.
Purpose of the Study:
- To evaluate the efficacy of active cathodal tDCS of the unaffected primary motor cortex (ctDCSM1UH) versus sham stimulation in improving upper limb motor function in early ischemic stroke patients.
- To investigate the effects of ctDCSM1UH on cognition and sleep in stroke survivors.
Main Methods:
- Thirty subjects within 6 weeks of ischemic stroke were randomized to receive six sessions of either active or sham ctDCSM1UH as an adjunct to rehabilitation.
- Assessments included NIH Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Barthel Index (BI), Stroke Impact Scale (SIS), and Montreal Cognitive Assessment (MoCA) at baseline, post-treatment, and 3-month follow-up.
Main Results:
- Intent-to-treat analysis revealed significant GROUP*TIME interactions favoring the sham group for improvements in NIHSS, FMA, BI, MoCA, and several SIS domains.
- At 3 months, the sham group showed significant improvements in FMA, NIHSS, BI, and SIS domains, while the active group did not demonstrate significant changes.
- Active ctDCSM1UH did not yield beneficial effects compared to sham, with no clinically relevant between-group differences observed.
Conclusions:
- Active cathodal tDCS of the unaffected motor cortex is not effective for improving motor, cognitive, or functional outcomes in the early phase after ischemic stroke.
- Findings align with previous studies using similar tDCS parameters or targeting severely impaired patients in the acute phase.
- Further dose-finding studies are required to determine optimal tDCS parameters for early stroke rehabilitation before conducting larger clinical trials.
