Etienne Ojardias1,2, Oscar Dagbémabou Azé1,3, Davy Luneau1, Janis Mednieks2,4, Agnès Condemine2, Diana Rimaud1,2, Fanette Chassagne5, Pascal Giraux1,2. 1. Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA, 7424, 42023, Saint-Etienne, France. 2. CHU Saint-Etienne, Service Médecine Physique et Réadaptation, F-42055, Saint-Etienne, France. 3. Laboratoire de Biomécanique et de Performance, Institut National de la Jeunesse, de l'Education Physique et du Sport (INJEPS)/ Université d'Abomey-Calavi (UAC), Porto-Novo, Bénin, Africa. 4. Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia. 5. Ecole Nationale Supérieure des Mines de Saint-Etienne, CIS-EMSE, Sainbiose, F-42023, Saint-Etienne, France.
Abstract
OBJECTIVE: To evaluate the effect of a single session of tDCS over the primary motor cortex of the lower limb (M1-LL) vs. placebo on the walking performance in chronic hemiplegic patients. PATIENTS AND METHODS: Randomized, cross-over, double-blinded study. Eighteen patients with initially complete hemiplegia and poststroke delay >6 months were included. Each patient received a single session of anodal stimulation (2 mA, 20 min) over M1-LL (a-tDCS condition) and a pseudostimulation session (SHAM condition). The order of the two sessions was randomly assigned, with an 11-day interval between the two sessions. The anodal electrode was centered on the hotspot identified with Transcranial magnetic stimulation. The cathode was placed above the contralesional orbitofrontal cortex. Walking performance was evaluated with the Wade test and the 6-minute walk test (6MWT), gait parameters with GAITRite, and balance with posturography. These tests were performed during and 1 hour after the stimulation. Baseline assessments were performed the day before and 10 days after each session. RESULTS: The comparison between the 6MWT under a-tDCS vs. SHAM conditions demonstrated a nonsignificant positive effect of the stimulation by 15% during stimulation (p = 0.360) and a significant positive effect of 25% 1 hour after stimulation (p = 0.038). No significant differences were observed for the other evaluations. DISCUSSION: These results showed a significant positive effect of a single session of anodal tDCS of the M1-LL in chronic hemiplegic patients. This proof-of-concept study supports the conduct of clinical studies evaluating the effectiveness of a walking training program associated with iterative tDCS stimulation. CONFLICT OF INTEREST: The authors reported no conflict of interest.
OBJECTIVE: To evaluate the effect of a single session of tDCS over the primary motor cortex of the lower limb (M1-LL) vs. placebo on the walking performance in chronic hemiplegic patients. PATIENTS AND METHODS: Randomized, cross-over, double-blinded study. Eighteen patients with initially complete hemiplegia and poststroke delay >6 months were included. Each patient received a single session of anodal stimulation (2 mA, 20 min) over M1-LL (a-tDCS condition) and a pseudostimulation session (SHAM condition). The order of the two sessions was randomly assigned, with an 11-day interval between the two sessions. The anodal electrode was centered on the hotspot identified with Transcranial magnetic stimulation. The cathode was placed above the contralesional orbitofrontal cortex. Walking performance was evaluated with the Wade test and the 6-minute walk test (6MWT), gait parameters with GAITRite, and balance with posturography. These tests were performed during and 1 hour after the stimulation. Baseline assessments were performed the day before and 10 days after each session. RESULTS: The comparison between the 6MWT under a-tDCS vs. SHAM conditions demonstrated a nonsignificant positive effect of the stimulation by 15% during stimulation (p = 0.360) and a significant positive effect of 25% 1 hour after stimulation (p = 0.038). No significant differences were observed for the other evaluations. DISCUSSION: These results showed a significant positive effect of a single session of anodal tDCS of the M1-LL in chronic hemiplegic patients. This proof-of-concept study supports the conduct of clinical studies evaluating the effectiveness of a walking training program associated with iterative tDCS stimulation. CONFLICT OF INTEREST: The authors reported no conflict of interest.
Authors: Bryant A Seamon; Mark G Bowden; John H Kindred; Aaron E Embry; Steven A Kautz Journal: J Clin Neurophysiol Date: 2021-04-08 Impact factor: 2.590
Authors: Xavier Corominas-Teruel; Rosa María San Segundo Mozo; Montserrat Fibla Simó; Maria Teresa Colomina Fosch; Antoni Valero-Cabré Journal: Front Neurol Date: 2022-09-07 Impact factor: 4.086