Virginie Sattler1, Blandine Acket1, Nicolas Raposo2, Jean-François Albucher2, Claire Thalamas3, Isabelle Loubinoux4, François Chollet1, Marion Simonetta-Moreau5. 1. Centre Hospitalier Universitaire de Toulouse, Toulouse, France Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France Université de Toulouse, Toulouse, France. 2. Centre Hospitalier Universitaire de Toulouse, Toulouse, France Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France. 3. Centre d'Investigation Clinique, CHU Purpan, Toulouse, France. 4. Inserm, Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France. 5. 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.
Abstract
BACKGROUND AND 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. CONCLUSION: 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.
RCT Entities:
BACKGROUND AND 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. CONCLUSION: 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: Pratik Y Chhatbar; Viswanathan Ramakrishnan; Steven Kautz; Mark S George; Robert J Adams; Wuwei Feng Journal: Brain Stimul Date: 2015-09-07 Impact factor: 8.955
Authors: Marom Bikson; Pnina Grossman; Chris Thomas; Adantchede Louis Zannou; Jimmy Jiang; Tatheer Adnan; Antonios P Mourdoukoutas; Greg Kronberg; Dennis Truong; Paulo Boggio; André R Brunoni; Leigh Charvet; Felipe Fregni; Brita Fritsch; Bernadette Gillick; Roy H Hamilton; Benjamin M Hampstead; Ryan Jankord; Adam Kirton; Helena Knotkova; David Liebetanz; Anli Liu; Colleen Loo; Michael A Nitsche; Janine Reis; Jessica D Richardson; Alexander Rotenberg; Peter E Turkeltaub; Adam J Woods Journal: Brain Stimul Date: 2016-06-15 Impact factor: 8.955