title: Combined central and peripheral stimulation to facilitate motor recovery after stroke: the effect of number of sessions on outcome.
abstract: BACKGROUND
  Proof-of-principle studies have demonstrated transient beneficial effects of transcranial direct current stimulation (tDCS) on motor function in stroke patients, mostly after single treatment sessions.
  
  
  OBJECTIVE
  To assess the efficacy of multiple treatment sessions on motor outcome.
  
  
  METHODS
  The authors examined the effects of two 5-day intervention periods of bihemispheric tDCS and simultaneous occupational/physical therapy on motor function in a group of 10 chronic stroke patients.
  
  
  RESULTS
  The first 5-day period yielded an increase in Upper-Extremity Fugl-Meyer (UE-FM) scores by 5.9 ± 2.4 points (16.6% ± 10.6%). The second 5-day period resulted in further meaningful, although significantly lower, gains with an additional improvement of 2.3 ± 1.4 points in UE-FM compared with the end of the first 5-day period (5.5% ± 4.2%). The overall mean change after the 2 periods was 8.2 ± 2.2 points (22.9% ± 11.4%).
  
  
  CONCLUSIONS
  The results confirm the efficacy of bihemispheric tDCS in combination with peripheral sensorimotor stimulation. Furthermore, they demonstrate that the effects of multiple treatment sessions in chronic stroke patients may not necessarily lead to a linear response function, which is of relevance for the design of experimental neurorehabilitation trials.
authors.affiliation: Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Lindenberg
authors.forename: Lin L
authors.initials: LL
authors.lastname: Zhu
authors.forename: Gottfried
authors.initials: G
authors.lastname: Schlaug
mesh_terms: D000328:Adult; D000368:Aged; D001703:Biophysics; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009044:Motor Cortex / Q000502:physiology*; D009788:Occupational Therapy / Q000379:methods*; D026741:Physical Therapy Modalities; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology