title: Neurostimulation for cognitive rehabilitation in stroke (NeuroCog): study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Stroke patients may present severe cognitive impairments, primarily related to executive functions. Transcranial direct current stimulation has shown promising results, with neuromodulatory and neuroplastic effects. This study is a double-blind, sham-controlled clinical trial aiming to compare the long-term effects of stimulation in two different cognitive regions after a stroke.
  
  
  METHODS
  Sixty patients who suffer from chronic strokes will be randomized into one of four groups: dorsolateral prefrontal cortex, cingulo-opercular network, motor primary cortex and sham stimulation. Each group will receive transcranial direct current stimulation at an intensity of 2 mA for 20 minutes daily for 10 consecutive days. Patients will be assessed with a Dysexecutive Questionnaire, Semantic Fluency Test, categorical verbal fluency and Go-no go tests, Wechsler Adult Intelligence Scale, Rey Auditory-Verbal Learning Test, Letter Comparison and Pattern Comparison Tasks at baseline and after their tenth stimulation session. Those who achieve clinical improvement with neurostimulation will be invited to receive treatment for 12 months as part of a follow-up study.
  
  
  CONCLUSIONS
  Long-term stimulation could be analyzed in regard to possible adaptive changes on plasticity after structural brain damage and if these changes are different in terms of clinical improvement when applied to two important cognitive centers.
  
  
  BACKGROUND
  Clinicaltrials.gov, NCT02315807 . 9 December 2014.
authors.affiliation: Cognitive Neuroscience and Behavior Program, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil. suellenandrade@gmail.com.
authors.forename: Suellen Marinho
authors.initials: SM
authors.lastname: Andrade
authors.affiliation: Cognitive Neuroscience and Behavior Program, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil. bfcalvo@usal.es.
authors.forename: Bernardino
authors.initials: B
authors.lastname: Fernández-Calvo
authors.affiliation: Cognitive Neuroscience Laboratory and Developmental Disorders Program, Mackenzie Presbyterian University, São Paulo, SP, Brazil. psboggio@gmail.com.
authors.forename: Paulo Sérgio
authors.initials: PS
authors.lastname: Boggio
authors.affiliation: Center for Research in Human Movement Sciences, Federal University of Paraíba, João Pessoa, PB, Brazil. elianeao@gmail.com.
authors.forename: Eliane Araújo
authors.initials: EA
authors.lastname: de Oliveira
authors.affiliation: Perception, Neurosciences and Behavior Laboratory, Federal University of Paraíba, João Pessoa, PB, Brazil. lilzeffg@yahoo.com.br.
authors.forename: Lilze Franklim
authors.initials: LF
authors.lastname: Gomes
authors.affiliation: Department of Sciences of Religions, NOUS Group, Federal University of Paraíbas, João Pessoa, PB, Brazil. juninho_eudes@hotmail.com.
authors.forename: José Eudes Gomes
authors.initials: JE
authors.lastname: Pinheiro Júnior
authors.affiliation: Perception, Neurosciences and Behavior Laboratory, Federal University of Paraíba, João Pessoa, PB, Brazil. rafaela.estagiaria@hotmail.com.
authors.forename: Rafaela Martins
authors.initials: RM
authors.lastname: Rodrigues
authors.affiliation: Perception, Neurosciences and Behavior Laboratory, Federal University of Paraíba, João Pessoa, PB, Brazil. natalialalmeida@hotmail.com.
authors.forename: Natália Leandro
authors.initials: NL
authors.lastname: de Almeida
authors.affiliation: Perception, Neurosciences and Behavior Laboratory, Federal University of Paraíba, João Pessoa, PB, Brazil. giocondasiqueira@gmail.com.
authors.forename: Gioconda Marla de Siqueira
authors.initials: GM
authors.lastname: Moreira
authors.affiliation: Cognitive Neuroscience and Behavior Program, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil. nelsontorro@yahoo.com.br.
authors.forename: Nelson Torro
authors.initials: NT
authors.lastname: Alves
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D002540:Cerebral Cortex / Q000503:physiopathology*; D002985:Clinical Protocols; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020127:Recovery of Function; D012107:Research Design; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors; D065908:Transcranial Direct Current Stimulation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult