title: Transcranial direct current stimulation facilitates motor learning post-stroke: a systematic review and meta-analysis.
abstract: Transcranial direct current stimulation (tDCS) is an attractive protocol for stroke motor recovery. The current systematic review and meta-analysis investigated the effects of tDCS on motor learning post-stroke. Specifically, we determined long-term learning effects by examining motor improvements from baseline to at least 5 days after tDCS intervention and motor practise. 17 studies reported long-term retention testing (mean retention interval=43.8 days; SD=56.6 days) and qualified for inclusion in our meta-analysis. Assessing primary outcome measures for groups that received tDCS and motor practise versus sham control groups created 21 valid comparisons: (1) 16 clinical assessments and (2) 5 motor skill acquisition tests. A random effects model meta-analysis showed a significant overall effect size=0.59 (p<0.0001; low heterogeneity, T(2)=0.04; I(2)=22.75%; and high classic fail-safe N=240). 4 moderator variable analyses revealed beneficial effects of tDCS on long-term motor learning: (1) stimulation protocols: anodal on the ipsilesional hemisphere, cathodal on the contralesional hemisphere, or bilateral; (2) recovery stage: subacute or chronic stroke; (3) stimulation timing: tDCS before or during motor practise; and (4) task-specific training or conventional rehabilitation protocols. This robust meta-analysis identified novel long-term motor learning effects with tDCS and motor practise post-stroke.
authors: Motor Behavior Laboratory, University of Florida, Gainesville, Florida, USA.
authors: Nyeonju
authors: N
authors: Kang
authors: Human Motor Control Laboratory, University of Tasmania, Hobart, Tasmania, Australia Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
authors: Jeffery J
authors: JJ
authors: Summers
authors: Motor Behavior Laboratory, University of Florida, Gainesville, Florida, USA.
authors: James H
authors: JH
authors: Cauraugh
mesh_terms: D006801:Humans; D007858:Learning; D009048:Motor Skills; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: CEREBROVASCULAR DISEASE; META-ANALYSIS; MOTOR CONTROL; STROKE; SYSTEMATIC REVIEWS