title: A double-blind, sham-controlled, pilot study to assess the effects of the concomitant use of transcranial direct current stimulation with the computer assisted cognitive rehabilitation to the prefrontal cortex on cognitive functions in patients with stroke.
abstract: OBJECTIVE
  To examine the synergistic effects of both computer-assisted cognitive rehabilitation (CACR) and transcranial direct current stimulation (tDCS) on cognitive function in patients with stroke.
  
  
  METHODS
  The current double-blind, sham-controlled study enrolled a total of 11 patients who were newly diagnosed with stroke. The patients of the tDCS group (n=6) completed sessions of the Korean computer-assisted cognitive rehabilitation program five times a week for 30 minutes a session during a mean period of 18.5 days concomitantly with the anodal tDCS over the bilateral prefrontal cortex combined with the CACR. The patients of the control group (n=5) also completed sessions of the sham stimulation during a mean period of 17.8 days. Anodal tDCS over bilateral prefrontal cortex (F3 and F4 in 10-20 EEG system) was delivered for 30 minutes at an intensity of 2 mA. Cathode electrodes were applied to the non-dominant arm. All the patients were evaluated using the Seoul Computerized Neuropsychological Test (SCNT) and the Korean Mini-Mental State Examination.
  
  
  RESULTS
  Mann-Whitney U test revealed a significant difference between the two groups. The patients of the tDCS group achieved a significant improvement in the post/pre ratio of auditory continuous performance test and visual continuous performance test on the SCNT items.
  
  
  CONCLUSIONS
  Our results indicate that the concomitant use of the tDCS with CACR to the prefrontal cortex may provide additional beneficial effects in improving the cognitive dysfunction for patients with stroke.
authors: Department of Physical Medicine & Rehabilitation, Chonbuk National University Medical School, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
authors: See-Hyun
authors: SH
authors: Park
authors: Department of Neurosurgery, Chonbuk National University School of Medicine, Jeonju, Korea.
authors: Eun-Jeong
authors: EJ
authors: Koh
authors: Department of Neurosurgery, Chonbuk National University School of Medicine, Jeonju, Korea.
authors: Ha-Young
authors: HY
authors: Choi
authors: Department of Physical Medicine & Rehabilitation, Chonbuk National University Medical School, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
authors: Myoung-Hwan
authors: MH
authors: Ko
keywords: Brain polarization; Cognitive function; Computer-assisted cognitive rehabilitation; Prefrontal cortex; Transcranial direct current stimulation