title: The ineffective role of cathodal tDCS in enhancing the functional motor outcomes in early phase of stroke rehabilitation: an experimental trial.
abstract: Transcranial direct current stimulation (tDCS) is a noninvasive technique that could improve the rehabilitation outcomes in stroke, eliciting neuroplastic mechanisms. At the same time conflicting results have been reported in subacute phase of stroke, when neuroplasticity is crucial. The aim of this double-blind, randomized, and sham-controlled study was to determine whether a treatment with cathodal tDCS before the rehabilitative training might augment the final outcomes (upper limb function, hand dexterity and manual force, locomotion, and activities of daily living) in respect of a traditional rehabilitation for a sample of patients affected by ischemic stroke in the subacute phase. An experimental group (cathodal tDCS plus rehabilitation) and a control group (sham tDCS plus rehabilitation) were assessed at the beginning of the protocol, after 10 days of stimulation, after 30 days from ending of stimulation, and at the end of inpatient rehabilitation. Both groups showed significant improvements for all the assessed domains during the rehabilitation, except for the manual force, while no significant differences were demonstrated between groups. These results seem to indicate that the cathodal tDCS, provided in an early phase of stroke, does not lead to a functional improvement. To depict a more comprehensive scenario, further studies are needed.
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Augusto
authors.identifier: 0000-0002-8528-7834
authors.initials: A
authors.lastname: Fusco
authors.affiliation: Department of Neurology, Campus Bio-Medico University, Via Álvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Assenza
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Marco
authors.identifier: 0000-0003-2434-3887
authors.initials: M
authors.lastname: Iosa
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Izzo
authors.affiliation: Department of Neurology, Campus Bio-Medico University, Via Álvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Riccardo
authors.identifier: 0000-0002-7637-9980
authors.initials: R
authors.lastname: Altavilla
authors.affiliation: Clinical Laboratory of Experimental Neurorehabilitation, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Paolucci
authors.affiliation: Department of Neurology, Campus Bio-Medico University, Via Álvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Vernieri
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D020521:Stroke / Q000503:physiopathology / Q000628:therapy; D000071939:Stroke Rehabilitation; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome