title: Increased resting state connectivity between ipsilesional motor cortex and contralesional premotor cortex after transcranial direct current stimulation with physical therapy.
abstract: Non-invasive stimulation of the brain using transcranial direct current stimulation (tDCS) during motor rehabilitation can improve the recovery of movements in individuals with stroke. However, the neural substrates that underlie the clinical improvements are not well understood. In this proof-of-principle open-label pilot study, five individuals with stroke received 10 sessions of tDCS while undergoing usual care physical/occupational therapy for the arm and hand. Motor impairment as indexed by the Upper Extremity Fugl Meyer assessment was significantly reduced after the intervention. Resting state fMRI connectivity increased between ipsilesional motor cortex and contralesional premotor cortex after the intervention. These findings provide preliminary evidence that the neural underpinnings of tDCS coupled with rehabilitation exercises, may be mediated by interactions between motor and premotor cortex. The latter, of which has been shown to play an important role in the recovery of movements post-stroke. Our data suggest premotor cortex could be tested as a target region for non-invasive brain-stimulation to enhance connectivity between regions that might be beneficial for stroke motor recovery.
authors.affiliation: Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute 2075 Bayview Avenue, M6-176 Toronto, Ontario, M4N 3M5, Canada.|Department of Physical Therapy and Rehabilitation Sciences Institute University of Toronto Toronto, Ontario, Canada.|Department of Neurology; Neuroimaging and Stroke Recovery Laboratory Beth Israel Deaconess Medical Center and Harvard Medical School Boston, MA, USA.
authors.forename: Joyce L
authors.initials: JL
authors.lastname: Chen
authors.affiliation: Department of Neurology; Neuroimaging and Stroke Recovery Laboratory Beth Israel Deaconess Medical Center and Harvard Medical School Boston, MA, USA.
authors.forename: Gottfried
authors.initials: G
authors.lastname: Schlaug
mesh_terms: D000368:Aged; D063132:Connectome; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology*; D010865:Pilot Projects; D012146:Rest / Q000502:physiology; D020521:Stroke / Q000503:physiopathology* / Q000628:therapy; D065908:Transcranial Direct Current Stimulation; D016896:Treatment Outcome