Bihemispheric tDCS for upper-limb hemiparesis in acute stroke: a randomized, double-blind, sham-controlled trial

Background and purpose: Neuromodulation is a promising approach to increase motor recovery in stroke. However, so far, there is a scarcity of evidence documenting the clinical potential of tDCS administered in the acute phase of stroke. The present study aims to examine the clinical effects of a treatment involving the application of tDCS in the acute stage post-stroke.

Methods: This is a randomized, double-blind, sham-controlled trial. A cohort of 32 stroke patients with severe motor impairment underwent a 5-days treatment with real or sham bi-hemispheric tDCS over the motor cortex. During the treatment, tDCS was applied twice per day (2 daily applications each of 15 min), starting 48-72 hours after stroke onset.

Results: We found statistically significant improvements after both real and sham tDCS treatments in primary (Hand Grip Strength, Motricity Index) and secondary (NIHSS, Barthel Index) outcomes. Patients receiving real tDCS showed a larger improvement of upper-limb muscle strength at the end of treatment phase; this advantage was not present any longer after 6 months.

Conclusions: tDCS may be used to accelerate the rate of upper-limb motor recovery during the spontaneous recovery period.

Keywords: acute stroke; hemiparesis; motor rehabilitation; tDCS.