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Effect of Transcranial Direct Current Stimulation on Motor Recovery in Patients with Subacute Stroke

Kim, Dae-Yul MD, PhD; Lim, Jong-Yub MD; Kang, Eun Kyoung MD, PhD; You, Dae Sang MD; Oh, Min-Kyun MD; Oh, Byung-Mo MD; Paik, Nam-Jong MD, PhD

American Journal of Physical Medicine & Rehabilitation: November 2010 - Volume 89 - Issue 11 - pp 879-886
doi: 10.1097/PHM.0b013e3181f70aa7
Original Research Article: Stroke

Kim DY, Lim JY, Kang EK, You DS, Oh MK, Oh BM, Paik NJ: Effect of transcranial direct current stimulation on motor recovery in patients with subacute stroke.

Objective: To test the hypothesis that 10 sessions of transcranial direct current stimulation combined with occupational therapy elicit more improvement in motor function of the paretic upper limb than sham stimulation in patients with subacute stroke.

Design: Eighteen patients with subacute stroke with hand motor impairment were randomly assigned to one of the three 10-day sessions of (a) anodal transcranial direct current stimulation over the affected motor cortex, (b) cathodal transcranial direct current stimulation over the unaffected motor cortex, or (c) sham stimulation. Blinded evaluators assessed upper limb motor impairment and global functional state with the Fugl-Meyer Assessment score and the Modified Barthel Index at baseline, 1 day after stimulation, and 6 mos after stimulation.

Results: Baseline scores for Fugl-Meyer Assessment and Modified Barthel Index were comparable in all groups (P > 0.05). At 6-mo follow-up, cathodal transcranial direct current stimulation led to a greater improvement in Fugl-Meyer Assessment than the sham procedure (P < 0.05). There was a significant inverse correlation between baseline Fugl-Meyer Assessment and Fugl-Meyer Assessment increase at 6 mos (r = −0.846; P < 0.01).

Conclusions: Our results suggest a potentially beneficial effect of noninvasive cortical stimulation during rehabilitative motor training of patients who have suffered from subacute strokes.

From the Department of Rehabilitation Medicine (DYK, DSY), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Department of Rehabilitation Medicine (JYL, EKK, M-KO, N-JP), Seoul National University Bundang Hospital, Seongnam, Republic of Korea; and Department of Rehabilitation Medicine (BMO, NJP), Seoul National University College of Medicine, Seoul, Republic of Korea.

All correspondence and requests for reprints should be addressed to Nam-Jong Paik, MD, PhD, Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong Bundang-gu, Seongnam 463-707, Republic of Korea.

Supported by a grant from Helping Water Foundation (to N.J.P.). Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Copyright © 2010 Wolters Kluwer Health, Inc. All rights reserved.