Brain Advance Access originally published online on January 5, 2005
Brain 2005 128(3):490-499; doi:10.1093/brain/awh369
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Published by Oxford University Press (2005)
Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke
1 Human Cortical Physiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA and 2 Cortical Physiology Research Group, Department of Neurology and Hertie Institute for Clinical Brain Research, Eberhard-Karls University Tuebingen, 72076 Tübingen, Germany
Correspondence: Leonardo G. Cohen, MD, Human Cortical Physiology Section, NINDS, NIH, Bethesda, MD 20817, USA E-mail: cohenl{at}ninds.nih.gov
Stroke is a leading cause of adult motor disability. Despite recent progress, recovery of motor function after stroke is usually incomplete. This double blind, Sham-controlled, crossover study was designed to test the hypothesis that non-invasive stimulation of the motor cortex could improve motor function in the paretic hand of patients with chronic stroke. Hand function was measured using the Jebsen–Taylor Hand Function Test (JTT), a widely used, well validated test for functional motor assessment that reflects activities of daily living. JTT measured in the paretic hand improved significantly with non-invasive transcranial direct current stimulation (tDCS), but not with Sham, an effect that outlasted the stimulation period, was present in every single patient tested and that correlated with an increment in motor cortical excitability within the affected hemisphere, expressed as increased recruitment curves (RC) and reduced short-interval intracortical inhibition. These results document a beneficial effect of non-invasive cortical stimulation on a set of hand functions that mimic activities of daily living in the paretic hand of patients with chronic stroke, and suggest that this interventional strategy in combination with customary rehabilitative treatments may play an adjuvant role in neurorehabilitation.
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