Τρίτη 20 Φεβρουαρίου 2018

Effects of anodal transcranial direct current stimulation on somatosensory recovery after stroke: a randomized controlled trial

AbstractObjectiveTo evaluate the effect of anodal transcranial direct current stimulation (tDCS) over the primary somatosensory cortex on the recovery of somatosensation, motor function, and the activities of daily living (ADL) in patients with subacute stroke.DesignThis study was a prospective, randomized sham controlled, double-blinded study. Patients with subacute stroke having somatosensory deficits (N = 24) were enrolled and assigned randomly to the anodal and sham stimulation groups. Patients received 10 consecutive anodal or sham tDCSs over the primary somatosensory cortex on the side of the stroke lesion. Before and after each stimulation session, Nottingham sensory assessments, Semmes Weinstein monofilaments examination, and manual function tests were performed, and modified Brunnstrom classification, modified Barthel index, and functional ambulation categories were assessed.ResultsAlthough there was no clear significant difference between the two groups, when the changes from baseline to post-treatment evaluation were compared between the groups, we observed a partially significant improvement in the anodal stimulation group compared to the sham stimulation group. Interestingly, the tactile sensation of the unaffected side also improved. Moreover, the greater improvement in ADL function was observed in the anodal stimulation group too.ConclusionAnodal tDCS over the primary somatosensory cortex may be a useful adjuvant therapy for the recovery of somatosensation and ADL function in patients with sensory deficits after stroke. Objective To evaluate the effect of anodal transcranial direct current stimulation (tDCS) over the primary somatosensory cortex on the recovery of somatosensation, motor function, and the activities of daily living (ADL) in patients with subacute stroke. Design This study was a prospective, randomized sham controlled, double-blinded study. Patients with subacute stroke having somatosensory deficits (N = 24) were enrolled and assigned randomly to the anodal and sham stimulation groups. Patients received 10 consecutive anodal or sham tDCSs over the primary somatosensory cortex on the side of the stroke lesion. Before and after each stimulation session, Nottingham sensory assessments, Semmes Weinstein monofilaments examination, and manual function tests were performed, and modified Brunnstrom classification, modified Barthel index, and functional ambulation categories were assessed. Results Although there was no clear significant difference between the two groups, when the changes from baseline to post-treatment evaluation were compared between the groups, we observed a partially significant improvement in the anodal stimulation group compared to the sham stimulation group. Interestingly, the tactile sensation of the unaffected side also improved. Moreover, the greater improvement in ADL function was observed in the anodal stimulation group too. Conclusion Anodal tDCS over the primary somatosensory cortex may be a useful adjuvant therapy for the recovery of somatosensation and ADL function in patients with sensory deficits after stroke. Corresponding author: Chung Reen Kim M.D., MS, Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Jeonha 1(il)-dong, Dong-gu, Ulsan, Korea. E-mail: crkim@uuh.ulsan.kr, Tel : 82-52-250-8730, Fax : 82-52-250-8071 We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated. No funds were received in support of this manuscript. Additionally, no benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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