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Tdcs acute stroke

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...
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...
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
Jose Torres, Daniel Drebing, Roy Hamilton
Aphasia is a common result of stroke, affecting over one million Americans. Currently, intensive speech therapy is the mainstay of treatment, although its efficacy has been variable at best. Recent years have seen the emergence of non-invasive brain stimulation, specifically Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS), as potential treatments for post-stroke aphasia. A growing body of investigations has shown the efficacy of both modalities in facilitating recovery from chronic aphasia, while data regarding subacute aphasia are much more limited and evidence in the acute post-stroke phase are still lacking...
2013: Restorative Neurology and Neuroscience
Samar S Ayache, Wassim H Farhat, Hela G Zouari, Hassan Hosseini, Veit Mylius, Jean-Pascal Lefaucheur
Noninvasive cortical stimulation (NICS) has been used during the acute, postacute and chronic poststroke phases to improve motor recovery in stroke patients having upper- and/or lower-limb paresis. This paper reviews the rationale for using the different NICS modalities to promote motor stroke rehabilitation. The changes in cortical excitability after stroke and the possible mechanisms of action of cortical stimulation in this context are outlined. A number of open and placebo-controlled trials have investigated the clinical effect of repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) of the primary motor cortex in patients with motor stroke...
August 2012: Expert Review of Neurotherapeutics
Timea M Hodics, Kyle Nakatsuka, Bhim Upreti, Arun Alex, Patricia S Smith, John C Pezzullo
OBJECTIVE: To extend the applicability of the Wolf Motor Function Test (WMFT) to describe the residual functional abilities of moderate to severely affected stroke patients. DESIGN: Data were collected as part of 2 double-blind, sham-controlled, randomized interventional studies: the Transcranial Direct Current Stimulation (tDCS) in Chronic Stroke Recovery and the tDCS Enhanced Stroke Recovery and Cortical Reorganization. Stroke patients were evaluated with the upper extremity Fugl-Meyer (UFM) and the WMFT in the same setting before treatment...
November 2012: Archives of Physical Medicine and Rehabilitation
C Rossi, F Sallustio, S Di Legge, P Stanzione, G Koch
BACKGROUND AND PURPOSE: Transcranial direct current stimulation (TDCS) is a potential tool to improve motor deficits in chronic stroke patients. Safety and efficacy of this procedure in acute stroke patients have not yet been addressed. METHODS:   We performed in our stroke unit a single-centre randomized, double-blind, sham-controlled study to investigate safety and efficacy of anodal TDCS of the affected hemisphere in acute stroke patients. The second day from stroke onset, 50 acute stroke patients received either five-daily sessions of anodal (n=25) at 2mA for 20min or sham TDCS (n=25) to the ipsilesional primary motor cortex (M1)...
January 2013: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Janine Reis, Brita Fritsch
PURPOSE OF REVIEW: Transcranial direct current stimulation (tDCS) has shown preliminary success in improving motor performance and motor learning in healthy individuals, and restitution of motor deficits in stroke patients. This brief review highlights some recent work. RECENT FINDINGS: Within the past years, behavioural studies have confirmed and specified the timing and polarity specific effects of tDCS on motor skill learning and motor adaptation. There is strong evidence that timely co-application of (hand/arm) training and anodal tDCS to the contralateral M1 can improve motor learning...
December 2011: Current Opinion in Neurology
Sandeep Kumar, Cynthia W Wagner, Colleen Frayne, Lin Zhu, Magdy Selim, Wuwei Feng, Gottfried Schlaug
BACKGROUND AND PURPOSE: Treatment options for stroke-related dysphagia are currently limited. In this study, we investigated whether noninvasive brain stimulation in combination with swallowing maneuvers facilitates swallowing recovery in dysphagic stroke patients during early stroke convalescence. METHODS: Fourteen patients with subacute unilateral hemispheric infarction were randomized to anodal transcranial direct current stimulation (tDCS) versus sham stimulation to the sensorimotor cortical representation of swallowing in the unaffected hemisphere over the course of 5 consecutive days with concurrent standardized swallowing maneuvers...
April 2011: Stroke; a Journal of Cerebral Circulation
Dorothee Wachter, Arne Wrede, Walter Schulz-Schaeffer, Ali Taghizadeh-Waghefi, Michael A Nitsche, Anna Kutschenko, Veit Rohde, David Liebetanz
OBJECTIVE: Transcranial direct current stimulation (tDCS) induces changes in cortical excitability and improves hand-motor function in chronic stroke. These effects depend on polarity, duration of stimulation and current intensity applied. Towards evaluating the therapeutic potential of tDCS in acute stroke, we investigated tDCS-effects on cerebral blood flow (CBF) in a tDCS rat model adapted for this purpose. METHODS: In a randomised crossover design eight Sprague-Dawley rats received three single cathodal and anodal tDCS for 15 min every other day...
February 2011: Experimental Neurology
Friedhelm C Hummel, Pablo Celnik, Alvero Pascual-Leone, Felipe Fregni, Winston D Byblow, Cathrin M Buetefisch, John Rothwell, Leonardo G Cohen, Christian Gerloff
Stroke is the leading cause of disability in the adult population of western industrialized countries. Despite significant improvements of acute stroke care, two thirds of stroke survivors have to cope with persisting neurologic deficits. Adjuvant brain stimulation is a novel approach to improving the treatment of residual deficits after stroke. Transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and epidural electrical stimulation have been used in first trials on small cohorts of stroke patients...
October 2008: Brain Stimulation
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