Transcranial direct current stimulation for gait recovery following stroke: A systematic review of current literature and beyond
BackgroundOver the last decade, transcranial direct current stimulation (tDCS) has set promise contributing to post-stroke gait rehabilitation. Even so, results are still inconsistent due to low sample size, heterogeneity of samples, and tDCS design differences preventing comparability. Nonetheless,...
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.953939/full |
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| author | Xavier Corominas-Teruel Xavier Corominas-Teruel Rosa María San Segundo Mozo Montserrat Fibla Simó Maria Teresa Colomina Fosch Antoni Valero-Cabré Antoni Valero-Cabré Antoni Valero-Cabré |
| author_facet | Xavier Corominas-Teruel Xavier Corominas-Teruel Rosa María San Segundo Mozo Montserrat Fibla Simó Maria Teresa Colomina Fosch Antoni Valero-Cabré Antoni Valero-Cabré Antoni Valero-Cabré |
| author_sort | Xavier Corominas-Teruel |
| collection | DOAJ |
| description | BackgroundOver the last decade, transcranial direct current stimulation (tDCS) has set promise contributing to post-stroke gait rehabilitation. Even so, results are still inconsistent due to low sample size, heterogeneity of samples, and tDCS design differences preventing comparability. Nonetheless, updated knowledge in post-stroke neurophysiology and stimulation technologies opens up opportunities to massively improve treatments.ObjectiveThe current systematic review aims to summarize the current state-of-the-art on the effects of tDCS applied to stroke subjects for gait rehabilitation, discuss tDCS strategies factoring individual subject profiles, and highlight new promising strategies.MethodsMEDLINE, SCOPUS, CENTRAL, and CINAHL were searched for stroke randomized clinical trials using tDCS for the recovery of gait before 7 February 2022. In order to provide statistical support to the current review, we analyzed the achieved effect sizes and performed statistical comparisons.ResultsA total of 24 records were finally included in our review, totaling n = 651 subjects. Detailed analyses revealed n = 4 (17%) studies with large effect sizes (≥0.8), n = 6 (25%) studies with medium ones (≥0.5), and n = 6 (25%) studies yielding low effects sizes (≤ 0.2). Statistically significant negative correlations (rho = −0.65, p = 0.04) and differences (p = 0.03) argued in favor of tDCS interventions in the sub-acute phase. Finally, significant differences (p = 0.03) were argued in favor of a bifocal stimulation montage (anodal M1 ipsilesional and cathodal M1 contralesional) with respect to anodal ipsilesional M1.ConclusionOur systematic review highlights the potential of tDCS to contribute to gait recovery following stroke, although also the urgent need to improve current stimulation strategies and subject-customized interventions considering stroke severity, type or time-course, and the use of network-based multifocal stimulation approaches guided by computational biophysical modeling.Systematic review registrationPROSPERO: CRD42021256347. |
| first_indexed | 2024-04-11T21:27:24Z |
| format | Article |
| id | doaj.art-265991e2173d45cf9295e10f5b21d3b5 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T21:27:24Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-265991e2173d45cf9295e10f5b21d3b52022-12-22T04:02:20ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-09-011310.3389/fneur.2022.953939953939Transcranial direct current stimulation for gait recovery following stroke: A systematic review of current literature and beyondXavier Corominas-Teruel0Xavier Corominas-Teruel1Rosa María San Segundo Mozo2Montserrat Fibla Simó3Maria Teresa Colomina Fosch4Antoni Valero-Cabré5Antoni Valero-Cabré6Antoni Valero-Cabré7Department of Psychology, Neurobehavior and Health Research Group (NEUROLAB), Universitat Rovira i Virgili, Tarragona, SpainCerebral Dynamics, Plasticity and Rehabilitation Group, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, Paris, FranceRehabilitation and Physical Medicine Department, Hospital Universitari Joan XXIII, Tarragona, SpainRehabilitation and Physical Medicine Department, Hospital Universitari Joan XXIII, Tarragona, SpainDepartment of Psychology, Neurobehavior and Health Research Group (NEUROLAB), Universitat Rovira i Virgili, Tarragona, SpainCerebral Dynamics, Plasticity and Rehabilitation Group, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, Paris, FranceCognitive Neuroscience and Information Tech. Research Program, Open University of Catalonia (UOC), Barcelona, SpainDepartment of Anatomy and Neurobiology, Laboratory of Cerebral Dynamics, Boston University School of Medicine, Boston, MA, United StatesBackgroundOver the last decade, transcranial direct current stimulation (tDCS) has set promise contributing to post-stroke gait rehabilitation. Even so, results are still inconsistent due to low sample size, heterogeneity of samples, and tDCS design differences preventing comparability. Nonetheless, updated knowledge in post-stroke neurophysiology and stimulation technologies opens up opportunities to massively improve treatments.ObjectiveThe current systematic review aims to summarize the current state-of-the-art on the effects of tDCS applied to stroke subjects for gait rehabilitation, discuss tDCS strategies factoring individual subject profiles, and highlight new promising strategies.MethodsMEDLINE, SCOPUS, CENTRAL, and CINAHL were searched for stroke randomized clinical trials using tDCS for the recovery of gait before 7 February 2022. In order to provide statistical support to the current review, we analyzed the achieved effect sizes and performed statistical comparisons.ResultsA total of 24 records were finally included in our review, totaling n = 651 subjects. Detailed analyses revealed n = 4 (17%) studies with large effect sizes (≥0.8), n = 6 (25%) studies with medium ones (≥0.5), and n = 6 (25%) studies yielding low effects sizes (≤ 0.2). Statistically significant negative correlations (rho = −0.65, p = 0.04) and differences (p = 0.03) argued in favor of tDCS interventions in the sub-acute phase. Finally, significant differences (p = 0.03) were argued in favor of a bifocal stimulation montage (anodal M1 ipsilesional and cathodal M1 contralesional) with respect to anodal ipsilesional M1.ConclusionOur systematic review highlights the potential of tDCS to contribute to gait recovery following stroke, although also the urgent need to improve current stimulation strategies and subject-customized interventions considering stroke severity, type or time-course, and the use of network-based multifocal stimulation approaches guided by computational biophysical modeling.Systematic review registrationPROSPERO: CRD42021256347.https://www.frontiersin.org/articles/10.3389/fneur.2022.953939/fullnon-invasive brain stimulation (NIBS)transcranial direct cortical stimulation (tDCS)strokeneurorehabilitationneuromodulationgait rehabilitation |
| spellingShingle | Xavier Corominas-Teruel Xavier Corominas-Teruel Rosa María San Segundo Mozo Montserrat Fibla Simó Maria Teresa Colomina Fosch Antoni Valero-Cabré Antoni Valero-Cabré Antoni Valero-Cabré Transcranial direct current stimulation for gait recovery following stroke: A systematic review of current literature and beyond Frontiers in Neurology non-invasive brain stimulation (NIBS) transcranial direct cortical stimulation (tDCS) stroke neurorehabilitation neuromodulation gait rehabilitation |
| title | Transcranial direct current stimulation for gait recovery following stroke: A systematic review of current literature and beyond |
| title_full | Transcranial direct current stimulation for gait recovery following stroke: A systematic review of current literature and beyond |
| title_fullStr | Transcranial direct current stimulation for gait recovery following stroke: A systematic review of current literature and beyond |
| title_full_unstemmed | Transcranial direct current stimulation for gait recovery following stroke: A systematic review of current literature and beyond |
| title_short | Transcranial direct current stimulation for gait recovery following stroke: A systematic review of current literature and beyond |
| title_sort | transcranial direct current stimulation for gait recovery following stroke a systematic review of current literature and beyond |
| topic | non-invasive brain stimulation (NIBS) transcranial direct cortical stimulation (tDCS) stroke neurorehabilitation neuromodulation gait rehabilitation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.953939/full |
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