Non-invasive cortical stimulation improves post-stroke attention decline.
OBJECTIVE
Attention decline after stroke is common and hampers the rehabilitation process, and non-invasive transcranial direct current stimulation (tDCS) has the potential to elicit behavioral changes by modulating cortical excitability. The authors tested the hypothesis that a single session of non-invasive cortical stimulation with excitatory anodal tDCS applied to the left dorsolateral prefrontal cortex (DLPFC) can improve attention in stroke patients.


METHODS
Ten patients with post-stroke cognitive decline (MMSE 25) and 10 age-matched healthy controls participated in this double blind, sham-controlled, crossover study involving the administration of real (2 mA for 20 min) or sham stimulation (2 mA for 1 min) to the left DLPFC. Attention was measured using a computerized Go/No-Go test before and after intervention. Improvements in accuracy and speed after stimulation relative to baseline were compared for real and sham stimulations.


RESULTS
In healthy controls, no significant improvement in Go/No-Go test was observed after either real or sham stimulation. However, in stroke patients, tDCS led to a significant improvement in response accuracy at 1 hour post-stimulation relative to baseline, and this improvement was maintained until 3 hours post-stimulation (P< 0.05), whereas sham stimulation did not lead to a significant improvement in response accuracy (P> 0.05). Changes in reaction times were comparable for the two stimulations (P> 0.05).


CONCLUSIONS
Non invasive anodal tDCS applied to the left DLPFC was found to improve attention versus sham stimulation in stroke patients, which suggests that non-invasive cortical intervention could potentially be used during rehabilitative training to improve attention.
Kang
Eun Kyoung
EK
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Baek
Min Jae
MJ
Kim
Sangyun
S
Paik
Nam-Jong
NJ
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology* / Q000628:therapy*; D016022:Case-Control Studies; D002755:Choice Behavior / Q000502:physiology; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy; D005221:Fatigue / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000502:physiology*; D020521:Stroke / Q000150:complications*; D016896:Treatment Outcome