ABSTRACT
STUDY DESIGN: Systematic review and meta-analysis. INTRODUCTION: Prior reviews on the effects of anodal transcranial direct current stimulation (a-tDCS) have shown the effectiveness of a-tDCS on corticomotor excitability and motor function in healthy individuals but nonsignificant effect in subjects with stroke. PURPOSE: To summarize and evaluate the evidence for the efficacy of a-tDCS in the treatment of upper limb motor impairment after stroke. METHODS: A meta-analysis of randomized controlled trials that compared a-tDCS with placebo and change from baseline. RESULTS: A pooled analysis showed a significant increase in scores in favor of a-tDCS (standard mean difference [SMD]=0.40, 95% confidence interval [CI]=0.10-0.70, p=0.010, compared with baseline). A similar effect was observed between a-tDCS and sham (SMD=0.49, 95% CI=0.18-0.81, p=0.005). CONCLUSION: This meta-analysis of eight randomized placebo-controlled trials provides further evidence that a-tDCS may benefit motor function of the paretic upper limb in patients suffering from chronic stroke. LEVEL OF EVIDENCE: Level 1a.
Subject(s)
Motor Skills/physiology , Paresis/rehabilitation , Stroke Rehabilitation , Transcranial Magnetic Stimulation/methods , Female , Follow-Up Studies , Humans , Male , Paresis/etiology , Randomized Controlled Trials as Topic , Risk Assessment , Stroke/complications , Survivors , Treatment Outcome , Upper Extremity/physiopathologyABSTRACT
This essay discusses the strengths and limitations of the new, growing field of law and biology and suggests that advancements in neuroscience can help to bolster that field. It also briefly discusses some ways that neuroscience can help to improve the workings of law more generally.