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Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: a review and meta-analysis

Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: a review and meta-analysis
Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: a review and meta-analysis
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. The extent of, and effect of variation in treatment parameters such as anodal, cathodal and bi-hemispheric tDCS on upper extremity outcome measures of impairment and activity were analysed using meta-analysis.

Results

Nine studies (371 participants with acute, sub-acute and chronic stroke) were included. Different methodologies of tDCS and upper extremity intervention, outcome measures and timing of assessments were identified. Real tDCS combined with rehabilitation had a small non-significant effect of +0.11 (p=0.44) and +0.24 (p=0.11) on upper extremity impairments and activities at post-intervention respectively.

Conclusion

Various tDCS methods have been used in stroke rehabilitation. The evidence so far is not statistically significant, but is suggestive of, at best, a small beneficial effect on upper extremity impairment.

Significance

Future research should focus on which patients and rehabilitation programmes are likely to respond to different tDCS regimes.
transcranial direct current stimulation, rehabilitation, stroke, upper extremity, recovery, non-invasive brain stimulation
946-955
Tedesco Triccas, L.
f058cdf1-9976-4f4b-a872-39b8739ba1bc
Burridge, J.H.
0110e9ea-0884-4982-a003-cb6307f38f64
Hughes, A.M.
11239f51-de47-4445-9a0d-5b82ddc11dea
Pickering, R.M.
4a828314-7ddf-4f96-abed-3407017d4c90
Desikan, M.
86520029-ab31-4fbc-b175-4158b59fcb67
Rothwell, J.C.
fea00de8-9734-4d9d-a017-c855f17df1c5
Verheyden, G.
dd0095fa-83d8-4ffd-af2f-fcef6f8a3997
Tedesco Triccas, L.
f058cdf1-9976-4f4b-a872-39b8739ba1bc
Burridge, J.H.
0110e9ea-0884-4982-a003-cb6307f38f64
Hughes, A.M.
11239f51-de47-4445-9a0d-5b82ddc11dea
Pickering, R.M.
4a828314-7ddf-4f96-abed-3407017d4c90
Desikan, M.
86520029-ab31-4fbc-b175-4158b59fcb67
Rothwell, J.C.
fea00de8-9734-4d9d-a017-c855f17df1c5
Verheyden, G.
dd0095fa-83d8-4ffd-af2f-fcef6f8a3997

Tedesco Triccas, L., Burridge, J.H., Hughes, A.M., Pickering, R.M., Desikan, M., Rothwell, J.C. and Verheyden, G. (2016) Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: a review and meta-analysis. Clinical Neurophysiology, 127 (1), 946-955. (doi:10.1016/j.clinph.2015.04.067).

Record type: Article

Abstract

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. The extent of, and effect of variation in treatment parameters such as anodal, cathodal and bi-hemispheric tDCS on upper extremity outcome measures of impairment and activity were analysed using meta-analysis.

Results

Nine studies (371 participants with acute, sub-acute and chronic stroke) were included. Different methodologies of tDCS and upper extremity intervention, outcome measures and timing of assessments were identified. Real tDCS combined with rehabilitation had a small non-significant effect of +0.11 (p=0.44) and +0.24 (p=0.11) on upper extremity impairments and activities at post-intervention respectively.

Conclusion

Various tDCS methods have been used in stroke rehabilitation. The evidence so far is not statistically significant, but is suggestive of, at best, a small beneficial effect on upper extremity impairment.

Significance

Future research should focus on which patients and rehabilitation programmes are likely to respond to different tDCS regimes.

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Triccas Multiple.pdf - Accepted Manuscript
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Multiple sessions of transcranial direct current stimulation and upper etremity rehabilitati in stroke - review Clin Neurophysiology.pdf - Accepted Manuscript
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More information

Accepted/In Press date: 15 April 2015
e-pub ahead of print date: 4 May 2015
Published date: 2016
Keywords: transcranial direct current stimulation, rehabilitation, stroke, upper extremity, recovery, non-invasive brain stimulation
Organisations: Faculty of Medicine, Faculty of Health Sciences

Identifiers

Local EPrints ID: 376915
URI: http://eprints.soton.ac.uk/id/eprint/376915
PURE UUID: 90d0b5db-5c46-4636-8a24-639f95a06914
ORCID for J.H. Burridge: ORCID iD orcid.org/0000-0003-3497-6725
ORCID for A.M. Hughes: ORCID iD orcid.org/0000-0002-3958-8206

Catalogue record

Date deposited: 13 May 2015 10:21
Last modified: 18 Feb 2021 17:06

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