title: Anodal tDCS Combined With Radial Nerve Stimulation Promotes Hand Motor Recovery in the Acute Phase After Ischemic Stroke.
abstract: OBJECTIVE
  The question of the best therapeutic window in which noninvasive brain stimulation (NIBS) could potentiate the plastic changes for motor recovery after a stroke is still unresolved. Most of the previous NIBS studies included patients in the chronic phase of recovery and very few in the subacute or acute phase. We investigated the effect of transcranial direct current stimulation (tDCS) combined with repetitive peripheral nerve stimulation (rPNS) on the time course of motor recovery in the acute phase after a stroke.
  
  
  METHODS
  Twenty patients enrolled within the first few days after a stroke were randomized in 2 parallel groups: one receiving 5 consecutive daily sessions of anodal tDCS over the ipsilesional motor cortex in association with rPNS and the other receiving the same rPNS combined with sham tDCS. Motor performance (primary endpoint: Jebsen and Taylor Hand Function Test [JHFT]) and transcranial magnetic stimulation cortical excitability measures were obtained at baseline (D1), at the end of the treatment (D5), and at 2 and 4 weeks' follow-up (D15 and D30).
  
  
  RESULTS
  The time course of motor recovery of the 2 groups of patients was different and positively influenced by the intervention (Group × Time interaction P = .01). The amount of improvement on the JHFT was greater at D15 and D30 in the anodal tDCS group than in the sham group.
  
  
  CONCLUSIONS
  These results show that early cortical neuromodulation with anodal tDCS combined with rPNS can promote motor hand recovery and that the benefit is still present 1 month after the stroke.
authors.affiliation: Centre Hospitalier Universitaire de Toulouse, Toulouse, France Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France Université de Toulouse, Toulouse, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Sattler
authors.affiliation: Centre Hospitalier Universitaire de Toulouse, Toulouse, France Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France Université de Toulouse, Toulouse, France.
authors.forename: Blandine
authors.initials: B
authors.lastname: Acket
authors.affiliation: Centre Hospitalier Universitaire de Toulouse, Toulouse, France Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Raposo
authors.affiliation: Centre Hospitalier Universitaire de Toulouse, Toulouse, France Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Albucher
authors.affiliation: Centre d'Investigation Clinique, CHU Purpan, Toulouse, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Thalamas
authors.affiliation: Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Loubinoux
authors.affiliation: Centre Hospitalier Universitaire de Toulouse, Toulouse, France Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France Université de Toulouse, Toulouse, France.
authors.forename: François
authors.initials: F
authors.lastname: Chollet
authors.affiliation: Centre Hospitalier Universitaire de Toulouse, Toulouse, France Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France Université de Toulouse, Toulouse, France simonetta.m@chu-toulouse.fr.
authors.forename: Marion
authors.initials: M
authors.lastname: Simonetta-Moreau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology; D009069:Movement Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D010865:Pilot Projects; D011826:Radial Nerve / Q000503:physiopathology*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: acute phase; peripheral nerve stimulation; rehabilitation; stroke; tDCS