Affiliations: [a] Department of Clinical Sciences Karolinska Institute, Danderyd University Hospital, Stockholm, Sweden
| [b]
Centre de Psychiatrie et Neurosciences, INSERM U894, Paris, France
| [c] FR3636 Neurosciences, CNRS, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| [d] Stockholm County Council Innovation, Danderyd University Hospital, Stockholm, Sweden
| [e] Leibniz Research Centre for Working Environment and Human Factors, Technical University of Dortmund, Dortmund, Germany
| [f] Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
Correspondence:
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Corresponding author: Elena L. Pavlova, Department of Clinical Sciences Karolinska Institute, Danderyd University Hospital SE-18288 Stockholm, Sweden. Tel.: +46 73 505 40 81, Fax: +46 8 655 77 54; E-mail: elena.pavlova@ki.se.
Abstract: Background: Recent studies exploring the combined effect of motor learning and transcranial direct current stimulation (tDCS) for stroke rehabilitation have shown partially conflicting results. Objective: To test the efficacy of an optimized hand training approach combined with tDCS in stroke patients. Methods: In the present pilot study we investigated motor effects of four-week training with a visuomotor grip force tracking task combined with tDCS in 11 chronic stroke patients. Anodal (0.5 mA) or sham tDCS was applied over the primary motor cortex of the lesioned side for 20 minutes, twice a day, during training. Results: No difference between the Active and Sham groups in the total upper extremity (UE) Fugl-Meyer Assessment (FMA) score was found. The most prominent recovery occurred in the shoulder-elbow FMA sub-score; in this segment a significantly greater improvement in the Active compared to the Sham group was observed up to two months after the intervention. Mean hold force during the first treatment session predicted the change in the total UE FMA score after treatment. Conclusion: Four-week visuo-motor training combined with tDCS showed no difference between the Active and Sham groups in the total UE FMA score, which may be explained by heterogeneity of the degree of recovery in the Active group. However, the shoulder-elbow FMA sub-score improved significantly more in the Active compared to the Sham group, which deserves further study.
Keywords: Transcranial direct current stimulation, visuo-motor training, chronic stroke, hand motor function, Fugl-Meyer assessment
