Abstract Details

Title Transcranial Direct Current Stimulation (tDCS) Enhanced Stroke Recovery and Cortical Reorganization

Topic Neuro-rehabilitation

Presentation(s) S10 - Neuro-rehabilitation: Neuromodulation (1:36 PM-1:48 PM)

Poster/Presentation
Number 004

Background Stroke is the most common cause of adult long-term disability. A noninvasive intervention, tDCS, may facilitate cortical plasticity and motor behavior in chronic stroke patients. It is desirable to develop noninvasive strategies to increase the effectiveness of rehabilitative therapy on motor recovery in the early phase after stroke when the speed of recovery is fastest.

Objective To determine whether tDCS application is feasible and safe early after stroke, and if it improves motor recovery of the upper extremity after stroke beyond what is achievable with standard rehabilitative treatment (SRT) alone.

Design/Methods

This is a randomized, controlled triple masked clinical trial. We enrolled patients who had a single ischemic stroke that resulted in moderate to severe hand weakness but were able to activate their hand or forearm muscles and could be safely included within 15 days of stroke onset.

Patients were randomized in one of the two study arms: standard rehabilitation therapy (SRT) + tDCS or in SRT + sham. Patients received 20 minutes of 1mA anodal tDCS or sham of the affected motor cortex simultaneously with SRT Monday-Friday for a total of ten sessions. Outcome measures were collected at discharge, 3 months and at 12 months.

Results We enrolled 36 (19 female) stroke patients. No severe treatment related adverse events occurred. Baseline upper extremity Fugl-Meyer (UFM) score was 22.6 ± 15.8 in the tDCS group and 21.2 ± 17.1 in the sham group. Immediate post-treatment UFM score was 30.2 ± 21.2 in the real stimulation group and 36.8 ± 22.4 in the sham group. (p=0.428). At 3 months follow-up UFM 32.4 ± 24.5 in the tDCS and 47.7 ± 18.7 in the sham group. (p=0.121)

Conclusions Study procedures were well tolerated, were feasible and safe. There was no significant difference in primary outcome measures between the tDCS and sham treatment groups.

Authors/Disclosures
Timea M. Hodics, MD (Houston Methodist Hospital) PRESENTER	An immediate family member of Dr. Hodics has received personal compensation for serving as an employee of CRG. An immediate family member of Dr. Hodics has stock in Approximately 40 public and private companies . An immediate family member of Dr. Hodics has received intellectual property interests from a discovery or technology relating to health care.
Alexander W. Dromerick, MD (National Rehabilitation Hospital)	No disclosure on file
	No disclosure on file
	No disclosure on file
Leonardo G. Cohen, MD	The institution of Dr. Cohen has received research support from NIH.