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Non-invasive alternating current stimulation induces recovery from stroke

Article type: Research Article

Authors: Fedorov, Anton | Chibisova, Yulia | Szymaszek, Aneta; | Alexandrov, Mikhail | Gall, Carolin | Sabel, Bernhard A.

Affiliations: Institute of Medical Psychology, Otto-von-Guericke-University Magdeburg, Leipziger Str., 44, 39120 Magdeburg, Germany | Mechnikov Medical Academy, Department of Neurology, Neurosurgery and Medical Genetics, Piskarevsky pr., 47, Saint-Petersburg, Russia | Nencki Institute of Experimental Biology, Laboratory of Neuropsychology, 3 Pasteur St., Warsaw, Poland

Note: [] Corresponding author: Bernhard A. Sabel, PhD, Institute of Medical Psychology, Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany. Tel.: +49 391 672 1800; Fax: +49 391 672 1803; E-mail: bernhard.sabel@med.ovgu.de

Keywords: Stroke, alternating current stimulation, recovery, aphasia, restoration

DOI: 10.3233/RNN-2010-0580

Journal: Restorative Neurology and Neuroscience, vol. 28, no. 6, pp. 825-833, 2010

Received 7 December 2010
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Accepted 7 December 2010
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Published: 2010
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Abstract

Background: Recovery of post-stroke deficits can be achieved by modulating neuroplasticity with non-invasive brain stimulation. To evaluate potential effects of repetitive transorbital alternating current stimulation (rtACS) on stroke recovery we carried out a randomized, drug-controlled clinical trial.

Methods: Ninety-eight patients that had suffered ischemic stroke 21.4 months earlier were randomly assigned to either group D (n=30) receiving conventional drug therapy, group ACS (n=32) treated for 12 days with rtACS, or group D/ACS (n=36) receiving combined drug therapy/rtACS. Stroke severity level (SSL) was assessed by the NIH-NINDS stroke scale before and after treatment and at a 1-month follow-up to evaluate motor impairments (weakness, ataxia), sensory loss, visual field defects, and cortical deficits (aphasia, neglect). At each time point standard EEG recordings (10–20 system) were conducted.

Results: Before therapy SSL was moderate (9.18 ± 0.78) without significant group difference (F =0.86, p=0.43). After 12 days of treatment, SSLs of groups ACS and D/ACS significantly improved by 22.5% and 25.1% over baseline, respectively, with no such change in the control group D (+3%). SSL improvements were mainly due to recovery of motor, sensory, and speech functions. After 1-month follow-up, an additional improvement of 9.7% and 9.4% was seen for the group ACS and D/ACS which led to a total change of +32.3% and +34.7% over baseline. EEG recordings revealed greater interhemispheric synchrony between both temporal lobes which were positively correlated with clinical outcome.

Conclusions: Non-invasive rtACS applied to post-stroke patients can modulate brain plasticity and induce recovery from neurological deficits long after the early post lesion recovery is over.

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