Effects of cerebellar transcranial direct current stimulation on rehabilitation of upper limb motor function after stroke

Qiuwen Gong; Rubing Yan; Han Chen; Xia Duan; Xiaoyu Wu; Xin Zhang; Yi Zhou; Zhou Feng; Ya Chen; Jianbo Liu; Peng Xu; Jing Qiu; Hongliang Liu; Jingming Hou

doi:10.3389/fneur.2023.1044333

Effects of cerebellar transcranial direct current stimulation on rehabilitation of upper limb motor function after stroke

Front Neurol. 2023 Mar 16:14:1044333. doi: 10.3389/fneur.2023.1044333. eCollection 2023.

Authors

Qiuwen Gong¹, Rubing Yan¹, Han Chen¹, Xia Duan¹, Xiaoyu Wu¹, Xin Zhang¹, Yi Zhou¹, Zhou Feng¹, Ya Chen¹, Jianbo Liu¹, Peng Xu², Jing Qiu³, Hongliang Liu¹, Jingming Hou¹

Affiliations

¹ Department of Rehabilitation, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
² School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
³ School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Chengdu, China.

Abstract

Background: The cerebellum is involved in the control and coordination of movements but it remains unclear whether stimulation of the cerebellum could improve the recovery of upper limb motor function. Therefore, this study aimed to explore whether cerebellar transcranial direct current stimulation (tDCS) therapy could promote the recovery of upper limb motor function in patients who suffered a stroke.

Methods: In this randomized, double-blind, and sham-controlled prospective study, 77 stroke patients were recruited and randomly assigned to the tDCS group (n = 39) or the control group (n = 38). The patients received anodal (2 mA, 20 min) or sham tDCS therapy for 4 weeks. The primary outcome was the change in the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score from baseline to the first day after 4 weeks of treatment (T1) and 60 days after 4 weeks of treatment (T2). The secondary outcomes were the FMA-UE response rates assessed at T1 and T2. Adverse events (AEs) related to the tDCS treatment were also recorded.

Results: At T1, the mean FMA-UE score increased by 10.7 points [standard error of the mean (SEM) = 1.4] in the tDCS group and by 5.8 points (SEM = 1.3) in the control group (difference between the two groups was 4.9 points, P = 0.013). At T2, the mean FMA-UE score increased by 18.9 points (SEM = 2.1) in the tDCS group and by 12.7 points (SEM = 2.1) in the control group (the difference between the two groups was 6.2 points, P = 0.043). At T1, 26 (70.3%) patients in the tDCS group had a clinically meaningful response to the FMA-UE score compared to 12 (34.3%) patients in the control group (the difference between the two groups was 36.0%, P =0.002). At T2, 33 (89.2%) patients in the tDCS group had a clinically meaningful response to the FMA-UE score compared with 19 (54.3%) patients in the control group (the difference between the two groups was 34.9%, P = 0.001). There was no statistically significant difference in the incidence of adverse events between the two groups. In the subgroup analysis of different hemiplegic sides, the rehabilitation effect of patients with right hemiplegia was better than that of patients with left hemiplegia (P < 0.05); in the age subgroup analysis, different age groups of patients did not show a significant difference in the rehabilitation effect (P > 0.05).

Conclusion: Cerebellar tDCS can be used as an effective and safe treatment to promote recovery of upper limb motor function in stroke patients.

Trial registration: ChiCTR.org.cn, identifier: ChiCTR2200061838.

Keywords: cerebellum; rehabilitation; stroke; transcranial direct current stimulation; upper limb motor function.

Grants and funding

This study was supported by the National Nature Science Foundation of China (U19A2082), the National Key Research and Development Program of China (2017YFC1308503), and the Chongqing Natural Science Foundation (2022WSJK009).