P78-S Transcranial direct current stimulation in chronic motor stroke: Preliminary results of a four-arm controlled study

Abstract

Background Transcranial direct current stimulation (tDCS) is a promising method for motor recovery in patients with stroke. At present different electrodes montages are used in motor stroke, but their comparative efficacy remains unclear. The aim of this study was to evaluate efficacy of different tDCS montages in chronic motor stroke. Materials and methods In this four-arm sham-controlled study 29 patients with chronic motor stroke were randomized into 4 groups: anodal tDCS over primary motor cortex (M1) of the lesional hemisphere (n = 7); cathodal tDCS over M1 of the contralesional hemisphere (n = 7); simultaneous bilateral stimulation (n = 8) and sham-stimulation (n = 7). Each patient received five stimulation sessions (20 min, 2 mA in active groups, one session per day) in combination with a course of standard physical rehabilitation. Participants were evaluated before and after stimulation with the upper extremity section of the Fugl-Meyer Assessment Scale (FM-UE) and the Modified Ashworth Scale (MAS) of muscle spasticity. Results The groups were not significantly different at baseline on age, duration after stroke, FM-UE and MAS scores. FM-UE score significantly improved after cathodal and bilateral tDCS, but not after anodal and sham-stimulation. There were no significant changes in MAS score in all groups. The effect of tDCS on motor function did not depend on baseline FM-UE score. Conclusions Our findings suggest that cathodal and bihemispheric stimulation improve motor function recovery in chronic stroke. Further studies are needed to determine predictors and compare efficacy of different tDCS protocols in chronic motor stroke.