Neurophysiological and behavioral effects of tDCS combined with constraint-induced movement therapy in poststroke patients.
Neurorehabil Neural Repair
; 25(9): 819-29, 2011.
Article
em En
| MEDLINE
| ID: mdl-21803933
ABSTRACT
BACKGROUND:
Recovery of motor function after stroke may depend on a balance of activity in the neural network involving the affected and the unaffected motor cortices.OBJECTIVE:
To assess whether transcranial direct current stimulation (tDCS) can increase the training-induced recovery of motor functions.METHODS:
In an exploratory study, 14 patients with chronic stroke and mean Fugl-Meyer Upper Extremity Motor Assessment of 29 (range = 8-50) entered a double-blind sham-controlled study, aimed to investigate neurophysiological and behavioral effects of bihemispheric tDCS (cathodal stimulation of the unaffected motor cortex and anodal stimulation of the affected motor cortex), combined with constraint-induced movement therapy (CIMT).RESULTS:
Patients in both groups demonstrated gains on primary outcome measures, that is, Jebsen Taylor Hand Function Test, Handgrip Strength, Motor Activity Log Scale, and Fugl-Meyer Motor Score. Gains were larger in the active tDCS group. Neurophysiological measurements showed a reduction in transcallosal inhibition from the intact to the affected hemisphere and increased corticospinal excitability in the affected hemisphere only in the active tDCS/CIMT group. Such neurophysiological changes correlated with the magnitude of the behavioral gains. Both groups showed a reduction in corticospinal excitability of the unaffected hemisphere.CONCLUSIONS:
CIMT alone appears effective in modulating local excitability but not in removing the imbalance in transcallosal inhibition. Bihemispheric tDCS may achieve this goal and foster greater functional recovery.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Terapia por Estimulação Elétrica
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Terapia Combinada
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Estimulação Magnética Transcraniana
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Terapia por Exercício
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Reabilitação do Acidente Vascular Cerebral
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Transtornos dos Movimentos
Tipo de estudo:
Clinical_trials
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Etiology_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article