Transcranial Direct Current Stimulation for Stroke Motor Recovery: What the TRANSPORT2 Trial Taught Us

Area of Science:

• Neuroscience
• Rehabilitation Medicine

Background:

• Transcranial direct current stimulation (tDCS) is a low-cost, user-friendly adjunctive therapy explored for enhancing motor recovery after stroke.
• Its neuromodulatory effects on motor cortical networks offer potential benefits for neuroplasticity.

Purpose of the Study:

• To critically examine barriers hindering the routine clinical translation of tDCS for post-stroke motor recovery.
• To outline strategies for refining tDCS application to optimize its effectiveness.

Main Methods:

• Topical review of challenges in tDCS application for stroke recovery.
• Analysis of device-related, disease-related, and trial design factors.
• Examination of recent multicenter trial outcomes, including TRANSPORT2.

Main Results:

• Despite promising potential, neutral results from recent multicenter trials highlight significant barriers to tDCS implementation.
• Progress is contingent upon addressing issues in stimulation parameters, patient characteristics, and trial design.

Conclusions:

• Refining tDCS application requires a multifaceted approach addressing device parameters, patient selection, and robust trial methodologies.
• Optimizing tDCS strategies is crucial for effectively leveraging neuromodulation to promote neuroplasticity and improve motor outcomes post-stroke.