Acute effects of bi-hemispheric transcranial direct current stimulation on the neuromuscular function of patients with chronic stroke: A randomized controlled study |
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| Institution: | 1. AP-HP, Raymond Poincaré Teaching Hospital, Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 805, Physiology–Functional Testing Ward, Garches, France;2. Université Côte d''Azur, LAMHESS, France;3. CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405 Orsay Cedex, France;4. CIAMS, Université d''Orléans, 45067 Orléans, France;5. AP-HP, Raymond Poincaré Teaching Hospital, CIC Inserm Unit 1429, Garches, France;6. Fondation Garches, Garches, France;7. Nantes Université, Mouvement - Interactions - Performance, MIP, EA 4334, F -44000 Nantes, France;1. Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, United States;2. Department of Neurology, Case Western Reserve University, Cleveland, OH, United States;3. Department of Neurology, Louis Stokes Department of Veterans Affairs Medical Center, Cleveland, OH, United States;4. Neurology Clinical Division, Neurology Department, Hospital das Clinicas, São Paulo University, São Paulo, Brazil;5. Hospital Israelita Albert Einstein, São Paulo, Brazil;6. Center for Neurological Restoration, Neurosurgery, Neurological Institute, Cleveland Clinic Foundation, Cleveland Clinic, United States;7. Department of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, United States;1. University of Aachen Medical Center, Department of Orthopaedic Trauma, Pauwelsstraße 30, 52074 Aachen, Germany;2. University of Aachen Medical Center, Department of Diagnostic and Interventional Radiology, Pauwelsstraße 30, 52074 Aachen, Germany;3. University of Zurich, Department of Trauma, Rämistrasse 100, 8091 Zürich, Switzerland |
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| Abstract: | BackgroundMuscle weakness in patients with chronic stroke is due to neuromuscular disorders such as muscle atrophy, loss of voluntary activation or weak muscle contractile properties which are majored by the imbalance of interhemispheric inhibition following stroke. In patients with chronic stroke, unilateral transcranial direct current stimulation improved the maximal isometric strength of paretic knee extensors, but bilateral transcranial direct current stimulation failed to improve concentric strength. This study aimed to assess if a bilateral current stimulation improves isometric maximal strength, voluntary activation and contractile properties of knee extensors in patients with chronic stroke.MethodsThirteen patients with chronic stroke and eight young healthy individuals participated in this randomized, simple-blinded, crossover study that included two experimental sessions: one with sham bilateral transcranial direct current stimulation and another with effective bilateral transcranial direct current stimulation (20 min, 2 mA). In the stroke patients, the anode was placed over the primary motor cortex of the affected hemisphere and the cathode over the contralateral primary motor cortex. In healthy participants, the brain side targeted by the anode and the cathode was randomly assigned. In each session, participants performed three assessments of strength, voluntary activation and contractile properties: before, during and after effective/sham bilateral transcranial direct current stimulation.FindingsBilateral transcranial direct current stimulation had no effect on any neuromuscular assessments in both groups (All P values > 0.05, partial eta-squares varied from 0.02 to 0.06).InterpretationA single session of bilateral transcranial direct current stimulation did not compensate muscular weakness of knee extensors in patients with chronic stroke. |
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