title: After vs. priming effects of anodal transcranial direct current stimulation on upper extremity motor recovery in patients with subacute stroke.
abstract: OBJECTIVE
  Transcranial direct current stimulation (tDCS) of the motor cortex seems to be effective in improving motor performance in patients with chronic stroke, while some recent findings have reported conflicting results for the subacute phase. We aimed to verify whether upper extremity motor rehabilitation could be enhanced by treatment with tDCS administered before a rehabilitative session.
  
  
  METHODS
  Hand dexterity and force in 16 individuals with subacute stroke were assessed before (T0) and after anodal stimulation (T1) and after a successive session of motor rehabilitation (T2) in a double-blind, randomized, sham-controlled, crossover trial. To confirm the value of the device as a specific effector, behavioral tests were also administered.
  
  
  RESULTS
  Anodal and sham stimulation plus rehabilitation significantly improved manual dexterity (repeated-measure Anova: A-tDCS: p = 0.005; S-tDCS: p = 0.042). Post hoc analysis revealed a significant stimulation effect only for A-tDCS (p = 0.013 between T0 and T1) and not for S-tDCS, whereas the rehabilitation effect (between T1 and T2) was not significant in either group. Hand force and behavioral features were unchanged.
  
  
  CONCLUSIONS
  Anodal brain stimulation improves hand dexterity but does not increase the effectiveness of the rehabilitation directly. These results suggest the presence of aftereffects, not priming effects, of A-tDCS superimposed onto motor learning phenomena.
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Augusto
authors.initials: A
authors.lastname: Fusco
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Marco
authors.initials: M
authors.lastname: Iosa
authors.affiliation: U.O.F Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Venturiero
authors.affiliation: U.O.F Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Domenico
authors.initials: D
authors.lastname: De Angelis
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Morone
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Luisa
authors.initials: L
authors.lastname: Maglione
authors.affiliation: U.O.F Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Maura
authors.initials: M
authors.lastname: Bragoni
authors.affiliation: U.O.F Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Paola
authors.initials: P
authors.lastname: Coiro
authors.affiliation: U.O.F Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Luca
authors.initials: L
authors.lastname: Pratesi
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome U.O.F Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome.
authors.forename: Stefano
authors.initials: S
authors.lastname: Paolucci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*
keywords: Brain stimulation; manual force; motor learning; stroke rehabilitation; upper limb function