Quantitative EEG Metrics for Determining HD-tDCS Induced Alteration of Brain Activity in Stroke Rehabilitation

High-definition transcranial direct current stimulation (HD-tDCS) is a promising approach for stroke rehabilitation, which may induce functional changes in the cortical sensorimotor areas to facilitate movement recovery. However, it lacks an objective measure that can indicate the effect of HD-tDCS on alteration of brain activity. Quantitative electroencephalography (qEEG) has shown promising results as an indicator of post-stroke functional recovery. Therefore, this study aims to determine whether qEEG metrics could serve as quantitative measures to assess alteration in brain activity induced by HD-tDCS. Resting state EEG was collected from stroke participants before and after (1) anodal HD-tDCS of the lesioned hemisphere, (2) cathodal stimulation of the non-lesioned hemisphere, and (3) sham. The average power spectrum was calculated using the Fast Fourier Transform for frequency bands alpha, beta, delta, and theta. In addition, delta-alpha ratio (DAR), Delta-alpha-beta-theta ratio (DTABR), and directional brain symmetry index (BSI) were also evaluated. We found that both anodal and cathodal stimulation significantly decreased the DAR and BSI over various frequency bands, which are associated with reduced motor impairments and improved nerve conduction velocity from the brain to muscles. This result indicates that qEEG metrics DAR and BSI could be quantitative indicators to assess alteration of brain activity induced by HD-tDCS in stroke rehabilitation. This would allow future development of EEG-based neurofeedback system to guide and evaluate the effect of HD-tDCS on improving movement-related brain function in stroke.