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Tdcs acute stroke

Wanalee Klomjai, Benchaporn Aneksan, Anuchai Pheungphrarattanatrai, Thanwarat Chantanachai, Nattha Choowong, Soontaree Bunleukhet, Paradee Auervitchayapat, Yongchai Nilanon, Vimonwan Hiengkaew
Anodal stimulation increases cortical excitably, whereas cathodal stimulation decreases cortical excitability. Dual transcranial direct current stimulation (tDCS; anodal over the lesioned hemisphere, cathodal over the non-lesioned hemisphere) was found to enhance motor learning. The corresponding tDCS-induced changes were reported to reduce the inhibition exerted by the unaffected hemisphere on the affected hemisphere and restore the normal balance of the interhemispheric inhibition. Most studies were devoted to the possible modification of upper-limb motor function after tDCS; however, almost no study has demonstrated its effects on lower-limb function and gait, which are also commonly disordered in stroke patients with motor deficits...
May 12, 2018: Annals of Physical and Rehabilitation Medicine
Sonja Suntrup-Krueger, Corinna Ringmaier, Paul Muhle, Andreas Wollbrink, Andre Kemmling, Uta Hanning, Inga Claus, Tobias Warnecke, Inga Teismann, Christo Pantev, Rainer Dziewas
OBJECTIVE: We evaluated whether transcranial direct current stimulation (tDCS) is able to enhance dysphagia rehabilitation following stroke. Besides relating clinical effects with neuroplastic changes in cortical swallowing processing, we aimed to identify factors influencing treatment success. METHODS: In this double-blind, randomized study, 60 acute dysphagic stroke patients received contralesional anodal (1mA, 20 minutes) or sham tDCS on 4 consecutive days. Swallowing function was thoroughly assessed before and after the intervention using the validated Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) and clinical assessment...
February 2018: Annals of Neurology
Mindy F Levin, Melanie C Baniña, Silvi Frenkel-Toledo, Sigal Berman, Nachum Soroker, John M Solomon, Dario G Liebermann
BACKGROUND: Recovery of voluntary movement is a main rehabilitation goal. Efforts to identify effective upper limb (UL) interventions after stroke have been unsatisfactory. This study includes personalized impairment-based UL reaching training in virtual reality (VR) combined with non-invasive brain stimulation to enhance motor learning. The approach is guided by limiting reaching training to the angular zone in which active control is preserved ("active control zone") after identification of a "spasticity zone"...
January 4, 2018: Trials
Shahram Oveisgharan, Hosein Organji, Askar Ghorbani
BACKGROUND: Two previous studies, which investigated transcranial direct current stimulation (tDCS) use in motor recovery after acute ischemic stroke, did not show tDCS to be effective in this regard. We speculated that additional left dorsolateral prefrontal cortex (DLPFC) stimulation may enhance poststroke motor recovery. METHODS: In the present randomized clinical trial, 20 acute ischemic stroke patients were recruited. Patients received real motor cortex (M1) stimulation in both arms of the trial...
January 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Suellen Marinho Andrade, José Jamacy de Almeida Ferreira, Thatiana Silva Rufino, Germana Medeiros, Jader Duarte Brito, Michele Alexandre da Silva, Raquel de Negreiros Moreira
BACKGROUND: Stroke is associated with high rates of falling and severe impairment of lower limb in patients who survive. OBJECTIVE: The aim of this study was to analyze the effectiveness of different montages of transcranial direct current stimulation (tDCS) on reducing falls and on lower limb function after acute stroke. METHODS: Sixty participants with acute stroke were randomly allocated into four groups with different electrode's setups: anodal, cathodal, bilateral and sham tDCS...
September 8, 2017: Neurological Research
Meheroz H Rabadi, Christopher E Aston
OBJECTIVE: The aim of this article was to determine whether cathodal transcranial direct current stimulation (c-tDCS) to unaffected primary motor cortex (PMC) plus conventional occupational therapy (OT) improves functional motor recovery of the affected arm hand in patients after an acute ischemic stroke compared with sham transcranial direct current stimulation plus conventional OT. DESIGN: In this prospective, randomized, double-blinded, sham-controlled trial of 16 severe, acute ischemic stroke patients with severe arm-hand weakness were randomly assigned to either experimental (c-tDCS plus OT; n = 8) or control (sham transcranial direct current stimulation plus OT; n = 8) groups...
October 2017: American Journal of Physical Medicine & Rehabilitation
Zoi Manoli, Marta Parazzini, Paolo Ravazzani, Theodoros Samaras
PURPOSE: The lack of knowledge of the electric field distribution inside the brain of stroke patients receiving transcranial direct current stimulation (tDCS) calls for estimating it computationally. Moreover, the impact on this distribution of a novel clinical management approach which involves secondary motor areas (SMA) in stroke rehabilitation needs to be evaluated. Finally, the differences in the electric field distributions due to gender and age need to be investigated. METHODS: This work presents the development of two different anatomical models (young adult female and elderly male) with an ischemic stroke region of spherical volume 10 cm(3) or 50 cm(3) , using numerical models of the Virtual Population (ViP)...
January 2017: Medical Physics
J Liepert, C Breitenstein
Advancements in medical care over the last decades have contributed to a continuous decline in immediate post-stroke mortality. The flipside of this development is that patients surviving the initial stroke are forced to live with sometimes extreme functional motor and/or language limitations for the remaining life span. The following overview presents evidence-based neurorehabilitative interventions to promote motor and language recovery in the acute and chronic post-stroke stages. Therapeutic approaches comprise intensive training, neuropharmacological drugs and non-invasive brain stimulation techniques, such as transcranial magnetic stimulation (TMS) or direct current stimulation (tDCS)...
December 2016: Der Nervenarzt
Nathalie Kubis
Brain plasticity after stroke remains poorly understood. Patients may improve spontaneously within the first 3 months and then more slowly in the coming year. The first day, decreased edema and reperfusion of the ischemic penumbra may possibly account for these phenomena, but the improvement during the next weeks suggests plasticity phenomena and cortical reorganization of the brain ischemic areas and of more remote areas. Indeed, the injured ischemic motor cortex has a reduced cortical excitability at the acute phase and a suspension of the topographic representation of affected muscles, whereas the contralateral motor cortex has an increased excitability and an enlarged somatomotor representation; furthermore, contralateral cortex exerts a transcallosal interhemispheric inhibition on the ischemic cortex...
2016: Frontiers in Neural Circuits
Kerstin Spielmann, W Mieke E van de Sandt-Koenderman, Majanka H Heijenbrok-Kal, Gerard M Ribbers
BACKGROUND: Transcranial direct current stimulation (tDCS) is a promising new technique to optimize the effect of regular Speech and Language Therapy (SLT) in the context of aphasia rehabilitation. The present study focuses on the effect of tDCS provided during SLT in the sub-acute stage after stroke. The primary aim is to evaluate the potential effect of tDCS on language functioning, specifically on word-finding, as well as generalization effects to verbal communication. The secondary aim is to evaluate its effect on social participation and quality of life, and its cost-effectiveness...
August 2, 2016: Trials
Nyeonju Kang, Jeffery J Summers, James H Cauraugh
BACKGROUND: Non-invasive brain stimulation (NIBS) facilitates motor improvements post stroke. Transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) are representative NIBS techniques frequently used in stroke motor rehabilitation. Our primary question is: Do these two techniques improve force production capability in paretic limbs? OBJECTIVE: The current systematic review and meta-analysis investigated the effects of tDCS and rTMS on paretic limb force production in stroke survivors...
September 2016: Brain Stimulation
Sofia Straudi, Felipe Fregni, Carlotta Martinuzzi, Claudia Pavarelli, Stefano Salvioli, Nino Basaglia
Objective. The aim of this exploratory pilot study is to test the effects of bilateral tDCS combined with upper extremity robot-assisted therapy (RAT) on stroke survivors. Methods. We enrolled 23 subjects who were allocated to 2 groups: RAT + real tDCS and RAT + sham-tDCS. Each patient underwent 10 sessions (5 sessions/week) over two weeks. Outcome measures were collected before and after treatment: (i) Fugl-Meyer Assessment-Upper Extremity (FMA-UE), (ii) Box and Block Test (BBT), and (iii) Motor Activity Log (MAL)...
2016: BioMed Research International
Bernhard Elsner, Joachim Kugler, Marcus Pohl, Jan Mehrholz
BACKGROUND: Stroke is one of the leading causes of disability worldwide. Functional impairment, resulting in poor performance in activities of daily living (ADLs) among stroke survivors is common. Current rehabilitation approaches have limited effectiveness in improving ADL performance, function, muscle strength and cognitive abilities (including spatial neglect) after stroke, but a possible adjunct to stroke rehabilitation might be non-invasive brain stimulation by transcranial direct current stimulation (tDCS) to modulate cortical excitability, and hence to improve ADL performance, arm and leg function, muscle strength and cognitive abilities (including spatial neglect), dropouts and adverse events in people after stroke...
March 21, 2016: Cochrane Database of Systematic Reviews
Rachel P Wood, Parag Khobragade, Leslie Ying, Kenneth Snyder, David Wack, Daniel R Bednarek, Stephen Rudin, Ciprian N Ionita
Perfusion imaging is the most applied modality for the assessment of acute stroke. Parameters such as Cerebral Blood Flow (CBF), Cerebral Blood volume (CBV) and Mean Transit Time (MTT) are used to distinguish the tissue infarct core and ischemic penumbra. Due to lack of standardization these parameters vary significantly between vendors and software even when provided with the same data set. There is a critical need to standardize the systems and make them more reliable. We have designed a uniform phantom to test and verify the perfusion systems...
February 21, 2015: Proceedings of SPIE
A V Blesneag, L Popa, A D Stan
The new tendency in rehabilitation involves non-invasive tools that, if applied early after stroke, promote neurorecovery. Repetitive transcranial magnetic stimulation and transcranial direct current stimulation may correct the disruption of cortical excitability and effectively contribute to the restoration of movement and speech. The present paper analyses the results of non-invasive brain stimulation (NIBS) trials, highlighting different aspects related to the repetitive transcranial magnetic stimulation frequency, transcranial direct current stimulation polarity, the period and stimulation places in acute and subacute ischemic strokes...
2015: Journal of Medicine and Life
L Tedesco Triccas, J H Burridge, A M Hughes, R M Pickering, M Desikan, J C Rothwell, G Verheyden
OBJECTIVE: To systematically review the methodology in particular treatment options and outcomes and the effect of multiple sessions of transcranial direct current stimulation (tDCS) with rehabilitation programmes for upper extremity recovery post stroke. METHODS: A search was conducted for randomised controlled trials involving tDCS and rehabilitation for the upper extremity in stroke. Quality of included studies was analysed using the Modified Downs and Black form...
January 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Virginie Sattler, Blandine Acket, Nicolas Raposo, Jean-François Albucher, Claire Thalamas, Isabelle Loubinoux, François Chollet, Marion Simonetta-Moreau
BACKGROUND AND OBJECTIVE: The question of the best therapeutic window in which noninvasive brain stimulation (NIBS) could potentiate the plastic changes for motor recovery after a stroke is still unresolved. Most of the previous NIBS studies included patients in the chronic phase of recovery and very few in the subacute or acute phase. We investigated the effect of transcranial direct current stimulation (tDCS) combined with repetitive peripheral nerve stimulation (rPNS) on the time course of motor recovery in the acute phase after a stroke...
September 2015: Neurorehabilitation and Neural Repair
Sarah Marchina, Gottfried Schlaug, Sandeep Kumar
GOAL: Dysphagia is a major stroke complication but lacks effective therapy that can promote recovery. Noninvasive brain stimulation with and without peripheral sensorimotor activities may be an attractive treatment option for swallowing recovery but has not been systematically investigated in the stroke population. This article describes the study design of the first prospective, single-center, double-blinded trial of anodal versus sham transcranial direct current stimulation (tDCS) used in combination with swallowing exercises in patients with dysphagia from an acute ischemic stroke...
March 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Vincenzo Di Lazzaro, Michele Dileone, Fioravante Capone, Giovanni Pellegrino, Federico Ranieri, Gabriella Musumeci, Lucia Florio, Giovanni Di Pino, Felipe Fregni
BACKGROUND: Significant changes in neurophysiological and clinical outcomes in chronic stroke had been reported after tDCS; but there is a paucity of data in acute stroke. OBJECTIVE: We aimed to evaluate whether a tDCS-induced modulation of primary motor cortex excitability in patients with acute stroke enhances motor recovery associated with rehabilitation and induces differential neuroplasticity. METHODS: We conducted two experiments in acute stroke patients...
November 2014: Brain Stimulation
Vassilios Tahtis, Diego Kaski, Barry M Seemungal
PURPOSE: Non-invasive brain stimulation with transcranial direct current stimulation (tDCS) modulates cortical excitability and improves upper limb motor performance when applied to chronic stroke patients. The objective was to evaluate whether tDCS can influence gait function in sub-acute stroke patients. METHODS: We assessed the effect of single session, bi-cephalic tDCS on gait performance in 14 subacute patients with stroke involving the cerebral hemisphere (2-8 weeks post-stroke) in a double-blinded, sham-controlled study...
2014: Restorative Neurology and Neuroscience
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