Transcranial direct current stimulation and suppression of contralesional primary motor cortex post-stroke: a systematic review and meta-analysis

Brain Inj. 2018;32(9):1063-1070. doi: 10.1080/02699052.2018.1481526. Epub 2018 Jun 1.

Abstract

Objective: The purpose of this systematic review and meta-analysis was to investigate the therapeutic effects of cathodal tDCS (ctDCS) that suppresses the contralesional primary motor cortex (cM1) activity for individuals with stroke in different recovery phases.

Methods: Fifteen studies that used ctDCS for suppressing the cM1 activity were included in this meta-analysis. Twenty total comparisons from the qualified studies identified motor function changes between ctDCS and sham protocols. We divided recovery stages into two categories: (a) acute and subacute phases (time since stroke ≤6 months): eight comparisons and (b) chronic phase (time since stroke >6 months): 12 comparisons.

Results: Random-effects meta-analysis models revealed motor improvements after applying ctDCS on the cM1 as indicated by a significant standardized effect size (ES = 0.61; P < 0.001). The moderator variable analysis showed that acute and subacute patients revealed no significant effect size of ctDCS (ES = 0.46; P = 0.07), whereas the ctDCS protocol significantly improved motor functions in chronic patients (ES = 0.71; P < 0.001).

Conclusion: This comprehensive meta-analysis indicates that the treatment effects of ctDCS on the cM1 are different between patients in the acute and subacute phases and patients in the chronic phase post-stroke.

Keywords: contralesional hemisphere; motor rehabilitation; primary motor cortex; stroke; tDCS.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Functional Laterality / physiology*
  • Humans
  • Motor Cortex / physiopathology*
  • Stroke / therapy*
  • Transcranial Direct Current Stimulation / methods*