Comparison of the after-effects of transcranial direct current stimulation over the motor cortex in patients with stroke and healthy volunteers.

It is known that weak transcranial direct current stimulation (tDCS) induces persistent excitability changes in the cerebral cortex. There are, however, few studies that compare the after-effects of anodal versus cathodal tDCS in patients with stroke. This study assessed the after-effects of tDCS over the motor cortex in patients with hemiparetic stroke and healthy volunteers. Seven stroke patients and nine healthy volunteers were recruited. Ten minutes of anodal and cathodal tDCS (1 mA) and sham stimulation were applied to the affected primary motor cortex (M1) on different days. In healthy subjects, tDCS was applied to the right M1. Before and after tDCS, motor-evoked potentials (MEPs) in the first dorsal interosseous (FDI) muscle and silent period were measured. Anodal tDCS increased the MEPs of the affected FDI in patients with stroke as well as in healthy subjects. Cathodal tDCS increased the MEPs of the affected FDI in patients with stroke. In healthy subjects, however, cathodal tDCS decreased the MEPs. We found no significant change in the duration of the silent period after anodal or cathodal tDCS. We found that both anodal and cathodal tDCS increased the affected M1 excitability in patients with stroke. It is thought that the after-effects of tDCS are different in patients with stroke compared with healthy subjects.