Transcranial direct current stimulation for upper and lower limb motor function in young people with Cerebral Palsy:...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Pediatric Neurology

Background:

• Cerebral palsy (CP) is the leading cause of motor disability in children.
• Current therapies often focus on single limb function, necessitating research into simultaneous upper and lower limb interventions.
• Transcranial direct current stimulation (tDCS) is an emerging non-invasive brain stimulation technique with potential as an adjuvant therapy for CP.

Purpose of the Study:

• To pilot the use of tDCS combined with upper and lower limb motor training in children with CP.
• To estimate the potential effect of this combined intervention on motor function.
• To investigate potential brain imaging correlates associated with motor function outcomes.

Main Methods:

• A randomized controlled trial involving 27 children (10-16 years) with CP.
• Participants received 10 sessions of either active or sham tDCS alongside motor training.
• Primary outcomes included upper limb function (Jebson Taylor Test) and lower limb function (Timed Up and Go Test) assessed one week post-intervention.

Main Results:

• The intervention was well-tolerated with good adherence (74% completed all sessions).
• No significant between-group differences were observed in upper or lower limb function at one week post-intervention.
• Baseline imaging revealed subtle associations between better hand function and increased grey matter volume in the caudate nucleus, and stronger sensorimotor resting-state connectivity.

Conclusions:

• The pilot study demonstrated that tDCS combined with motor training is safe and feasible for children with CP.
• The observed effect sizes were small, and no significant functional improvements were detected in this pilot.
• Larger, powered studies are required to further evaluate the efficacy of tDCS as an adjuvant therapy for CP affecting multiple limbs.