Transcranial direct current stimulation for improving upper limb function after stroke

Stroke is one of the main causes of long-term disability, and hemiparesis is a common disability following stroke. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that can modulate cortical and subcortical excitability by inducing a weak, direct current via electrodes placed over the scalp. Several studies, mainly performed in the chronic or subacute recovery phase after stroke, have reported a tDCS-induced functional motor improvement of the paretic hand. Various tDCS strategies, following a model of interhemispheric rivalry between the damaged and intact hemispheres, have been found to promote motor recovery. This suggests that motor recovery may be facilitated by upregulating the excitability of the affected motor cortex through anodal tDCS, down-regulating the excitability of the intact motor cortex through cathodal tDCS, or through bihemispheric anodal/cathodal tDCS. tDCS may facilitate stroke rehabilitation by restoring the balance between the hemispheres and combined with physical or occupational therapy can improve functional motor outcome. Several combination trials have been performed such as tDCS and robot-assisted arm-training, peripheral nerve stimulation, constraint-induced movement therapy, facilitating the beneficial effects in comparison with each intervention alone. Brain-derived neurotrophic factor (BDNF) plays an important role in neuronal plasticity and the pathophysiology of brain disorders. BDNF Val66Met genotype may moderate the response to tDCS on post-stroke upper limb hemiparesis. Moreover, tDCS may alter BDNF and is therefore influenced by BDNF gene polymorphism.

• Publication year

  2019

• Venue

  Japanese Journal of Stroke

• Publication date

  Unknown publication date

• Fields of study

  Medicine

• Identifiers
  DOI 10.3995/jstroke.10681
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

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