Stroke Clinical Trial
Official title:
The Effect of Bihemispheric Transcranial Direct Current Stimulation Therapy on Upper Extremity Motor Functions in Stroke Patients
Motor impairment (impairment of movement) due to stroke is one of the leading disabilities in
adults. In addition to established means of facilitating motor recovery after stroke such as
physical and occupational therapy, a variety of experimental rehabilitation approaches have
been tested. Although there have been significant advances in stroke rehabilitation with
these techniques and treatments, research on this subject is continuing. Recent studies have
focused on non-invasive brain stimulation techniques. Transcranial magnetic stimulation (TMS)
or transcranial direct current stimulation (tDCS) therapies, which are methods of
non-invasive brain stimulation that may be effective on cerebral remodelling, aim to
reestablish the disturbed balance between the anatomic areas of the brain seen in stroke
patients.
The primary aim of this study is to evaluate the effectiveness of bihemispheric transcranial
direct current stimulation (tDCS) applications on the upper extremity motor functions of
patients with stroke.
Motor impairment due to ischemic and hemorrhagic stroke is one of the leading disabilities in
adults. In addition to established means of facilitating motor recovery after stroke such as
physical and occupational therapy, a variety of experimental rehabilitation approaches have
been tested. Recent developments include noninvasive brain stimulation techniques such as
repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current
stimulation (tDCS). The use of these tools is based on neurophysiologic studies demonstrating
an imbalance of interhemispheric interactions which appears to interfere with the recovery
process.
The model of interhemispheric imbalance provides a framework for developing hypotheses based
on its 2 facets: 1) upregulating excitability of intact portions of the ipsilesional motor
cortex and 2) downregulating excitability of the contralesional motor cortex to modulate its
unrestrained inhibitory influence on ipsilesional regions. Studies to date have shown have
shown the beneficial effects of tDCS on motor skills and motor learning.
Bihemispheric tDCS may potentiate the effects of anodal stimulation to the lesional
hemisphere through additional modulation of interhemispheric interactions via cathodal
stimulation to the contralesional motor cortex.
The primary aim of this prospective, randomized, sham controlled study is to evaluate the
effectiveness of bihemispheric transcranial direct current stimulation (tDCS) applications on
the upper extremity motor functions of patients with stroke.
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