title: Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke.
abstract: Stroke is a leading cause of adult motor disability. Despite recent progress, recovery of motor function after stroke is usually incomplete. This double blind, Sham-controlled, crossover study was designed to test the hypothesis that non-invasive stimulation of the motor cortex could improve motor function in the paretic hand of patients with chronic stroke. Hand function was measured using the Jebsen-Taylor Hand Function Test (JTT), a widely used, well validated test for functional motor assessment that reflects activities of daily living. JTT measured in the paretic hand improved significantly with non-invasive transcranial direct current stimulation (tDCS), but not with Sham, an effect that outlasted the stimulation period, was present in every single patient tested and that correlated with an increment in motor cortical excitability within the affected hemisphere, expressed as increased recruitment curves (RC) and reduced short-interval intracortical inhibition. These results document a beneficial effect of non-invasive cortical stimulation on a set of hand functions that mimic activities of daily living in the paretic hand of patients with chronic stroke, and suggest that this interventional strategy in combination with customary rehabilitative treatments may play an adjuvant role in neurorehabilitation.
authors.affiliation: Human Cortical Physiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20817, USA.
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Hummel
authors.forename: Pablo
authors.initials: P
authors.lastname: Celnik
authors.forename: Pascal
authors.initials: P
authors.lastname: Giraux
authors.forename: Agnes
authors.initials: A
authors.lastname: Floel
authors.forename: Wan-Hsun
authors.initials: WH
authors.lastname: Wu
authors.forename: Christian
authors.initials: C
authors.lastname: Gerloff
authors.forename: Leonardo G
authors.initials: LG
authors.lastname: Cohen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D010243:Paralysis / Q000209:etiology / Q000534:rehabilitation*; D011597:Psychomotor Performance; D011601:Psychophysics; D020127:Recovery of Function; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation