Combining muscle-computer interface guided training with bihemispheric tDCS improves upper limb function in patients...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Transcranial direct current stimulation (tDCS) shows potential for neuroplasticity but has limited effects during rest in stroke patients.
• Muscle-computer interface (MCI) training offers a promising avenue for stroke rehabilitation, even for individuals with limited movement.
• The combined effect of tDCS and MCI training for stroke recovery remains largely unexplored.

Purpose of the Study:

• To investigate the efficacy of combining bihemispheric tDCS with MCI training for the paretic wrist in patients with chronic stroke.
• To evaluate the impact of this combined intervention on upper limb motor function.

Main Methods:

• A crossover, double-blind, randomized trial involving 26 chronic stroke patients.
• Participants underwent three consecutive days of home-based MCI wrist training, receiving either real or sham bihemispheric tDCS in a counterbalanced order.
• The Fugl-Meyer Assessment Upper Extremity (FMA-UE) scale was the primary outcome measure, assessed at multiple time points.

Main Results:

• Patients receiving real tDCS showed a significant improvement of 3.9 points in FMA-UE scores, compared to 1.0 point with sham tDCS (P = 0.003).
• No significant differences in baseline FMA-UE scores were observed between groups or intervention periods.
• Continuous improvement in motor control of MCI tasks was noted throughout the training days.

Conclusions:

• Bihemispheric tDCS combined with MCI training can significantly improve upper limb function in chronic stroke survivors.
• This combined approach demonstrates a training-specific effect on wrist movement and offers a potential adjuvant therapy for neurorehabilitation.
• The personalized and adjustable nature of the training regimen suggests its utility in complementing conventional stroke rehabilitation strategies.