Abstract
Transcranial direct current stimulation (tDCS) is a noninvasive technique that could improve the rehabilitation outcomes in stroke, eliciting neuroplastic mechanisms. At the same time conflicting results have been reported in subacute phase of stroke, when neuroplasticity is crucial. The aim of this double-blind, randomized, and sham-controlled study was to determine whether a treatment with cathodal tDCS before the rehabilitative training might augment the final outcomes (upper limb function, hand dexterity and manual force, locomotion, and activities of daily living) in respect of a traditional rehabilitation for a sample of patients affected by ischemic stroke in the subacute phase. An experimental group (cathodal tDCS plus rehabilitation) and a control group (sham tDCS plus rehabilitation) were assessed at the beginning of the protocol, after 10 days of stimulation, after 30 days from ending of stimulation, and at the end of inpatient rehabilitation. Both groups showed significant improvements for all the assessed domains during the rehabilitation, except for the manual force, while no significant differences were demonstrated between groups. These results seem to indicate that the cathodal tDCS, provided in an early phase of stroke, does not lead to a functional improvement. To depict a more comprehensive scenario, further studies are needed.
Highlights
Due to increase of life expectancy, adults are progressively more exposed to vascular diseases, as stroke [1]
The aim of this double-blind, randomized, and sham-controlled study was to determine whether a treatment with cathodal Transcranial direct current stimulation (tDCS) before the rehabilitative training might augment the final outcomes in respect of a traditional rehabilitation for a sample of patients affected by ischemic stroke in the subacute phase
To facilitate the spontaneous mechanisms of neuroplasticity, we developed this experimental protocol at an early phase of stroke rehabilitation
Summary
Due to increase of life expectancy, adults are progressively more exposed to vascular diseases, as stroke [1]. A large amount of evidence has shown a wide brain cells’ activity after damage [3]. This seems to be related to the neuroplasticity of the CNS and has fundamental implications for neurologic rehabilitation in terms of outcome improvements [4,5,6]. Neuroplasticity is defined as the brain’s ability to reorganize itself by forming new neural connections throughout the life, allowing to adapt the brain in response to situations or requests derived from the environment and/or in response to an internal damage [7, 8]. Despite the fact that structural changes related to a reorganization of the 6 preexisting networks and the axonal sprouting have been demonstrated to occur in brain cells, the mechanisms of neuroplasticity are not completely elucidated
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