Therapeutic Effects of Diagonal-Transcranial Direct Current Stimulation on Functional Recovery in Acute Stroke: A Pilot Study |
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| Affiliation: | 2. Department of Rehabilitation, Toyama Prefectural Rehabilitation Hospital and Support Center for Children with Disabilities, Toyama, Japan;3. Department of Rehabilitation, University of Toyama, Toyama, Japan;2. Department of Neurosurgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 8795593, Japan;2. Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane West, Piscataway, NJ 08854, USA;3. Department of Biochemistry and Molecular Biology, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane West, Piscataway, NJ 08854, USA;2. Department of Neurology, Creighton University School of Medicine, Omaha, NE;3. Department of Neurology, University of Texas Rio Grande Valley, Department of Neuroscience, Valley Baptist Hospital, Harlingen, TX;4. St. Cloud Hospital, St. Cloud, MN;2. Neuroradiology Unit, Fondation Rothschild Hospital, Paris, France;3. Neurovascular Unit, Foch Hospital, Suresnes, France;4. Neurovascular Unit, Foch Hospital, Suresnes, France;5. Interventional Neuroradiology Unit, Fondation Rothschild Hospital, Paris, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France; Université Paris Denis Diderot, Sorbonne Paris Cite, France;2. Paediatric Unit, Meyer Children''s Hospital, Viale Pieraccini 24, Florence 50139, Italy;3. Child Neurology Unit, Meyer Children''s Hospital, Viale Pieraccini, 24 Florence 50139, Italy;4. Professor NEUROFARBA Department, Meyer Children''s Hospital, Viale Pieraccini 24, Florence 50139, Italy |
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| Abstract: | Background: Peak neurologic recovery from acute stroke occurs within the first 3 months, and continues at a slower pace for 6 months. Objective/Hypothesis: The aim of this pilot study is to clarify the safety and feasibility of multiple diagonal-transcranial direct current stimulation (d-tDCS) sessions up to 3 months with electrodes placed diagonally over the lesional dorsolateral prefrontal cortex and contralesional primary motor cortex for upper limb hemiparesis in acute stroke. Methods: Five patients with acute stroke (2 with intracerebral hemorrhage and 3 with cerebral infarction) with upper limb paresis participated. d-tDCS (1 mA, 20 min per day) combined with conventional rehabilitation was given starting 7–21 days after stroke onset. Each session consisted of 10 d-tDCS over 2 weeks and patients received 2 sessions in the acute phase and 2 sessions in the subacute phase for a total 40 treatments. Motor function was assessed using Fugl-Meyer Assessment for upper extremity (FMA-UE) before and after each session, and the period to achieve 70% of maximal potential recovery in FMA-UE was evaluated. Results: All 5 patients completed the intervention and showed no adverse effects throughout the protocol. Of these, 3 (60%) achieved 70% predicted scores within 2 months. Regarding therapeutic gains of FMA-UE in each of the 10 sessions in the acute phase, 4 sessions showed great recovery, 3 sessions showed moderate recovery, and 3 sessions showed poor recovery. Conclusion: These findings suggest that d-tDCS over 3 months may be safe and feasible for acute stroke patients in the acute to subacute phases and have therapeutic potential to promote recovery of upper limb function, although further randomized, double-blind, sham-controlled trial is warranted with larger sample size. |
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