title: Combination of transcranial direct current stimulation and methylphenidate in subacute stroke.
abstract: Noninvasive transcranial direct current stimulation (tDCS) and methylphenidate (MP) are associated with motor recovery after stroke. Based on the potentially complementary mechanisms of these interventions, we examined whether there is an interactive effect between MP and tDCS. In this preliminary study, we randomized subacute stroke subjects to receive tDCS alone, MP alone or combination of tDCS and MP. A blinded rater measured safety, hand function, and cortical excitability before and after treatment. None of the treatments caused any major or severe adverse effects or induced significant differences in cortical excitability. Analysis of variance of gain score, as measured by Purdue pegboard test, showed a significant between-group difference (F(2,6)=12.167, p=0.008). Post hoc analysis showed that the combination treatment effected greater Purdue pegboard gain scores than tDCS alone (p=0.017) or MP alone (p=0.01). Our preliminary data with nine subjects shows an interesting dissociation between motor function improvement and lack of motor corticospinal plasticity changes as indexed by transcranial magnetic stimulation in subacute stroke subjects.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States.
authors.forename: Qing Mei
authors.initials: QM
authors.lastname: Wang
authors.affiliation: Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, China; Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States.
authors.forename: Huashun
authors.initials: H
authors.lastname: Cui
authors.affiliation: Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Department of Rehabilitation Medicine, School of Medicine, Ewha Womans University, Republic of Korea.
authors.forename: Soo Jeong
authors.initials: SJ
authors.lastname: Han
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States.
authors.forename: Randie
authors.initials: R
authors.lastname: Black-Schaffer
authors.affiliation: Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Charité - Universitätsmedizin Berlin, Medical Department I Gastroenterology, Infectiology and Rheumatology, Berlin, Germany.
authors.forename: Magdalena Sarah
authors.initials: MS
authors.lastname: Volz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States.
authors.forename: Yong-Tae
authors.initials: YT
authors.lastname: Lee
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States.
authors.forename: Seth
authors.initials: S
authors.lastname: Herman
authors.affiliation: Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Malaysia.
authors.forename: Lydia Abul
authors.initials: LA
authors.lastname: Latif
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States.
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
authors.affiliation: Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States. Electronic address: fregni.felipe@mgh.harvard.edu.
authors.forename: Felipe
authors.initials: F
authors.lastname: Fregni
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000503:physiopathology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D008875:Middle Aged; D009048:Motor Skills; D020521:Stroke / Q000503:physiopathology / Q000628:therapy*; D011795:Surveys and Questionnaires; D065908:Transcranial Direct Current Stimulation
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate
keywords: Cortical excitability; Methylphenidate; TMS; tDCS