Determining the effects of targeted high-definition transcranial direct current stimulation on reducing post-stroke upper limb motor impairments—a randomized cross-over study
Abstract Background Stroke is one of the leading causes of death in the USA and is a major cause of serious disability for adults. This randomized crossover study examines the effect of targeted high-definition transcranial direct current transcranial brain stimulation (tDCS) on upper extremity moto...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Trials |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13063-023-07886-w |
| _version_ | 1797355522614099968 |
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| author | Rita Huan-Ting Peng Dorothy He Shirley A. James Jordan N. Williamson Carly Skadden Sanjiv Jain Wael Hassaneen Amrendra Miranpuri Amandeep Kaur Jesus N. Sarol Yuan Yang |
| author_facet | Rita Huan-Ting Peng Dorothy He Shirley A. James Jordan N. Williamson Carly Skadden Sanjiv Jain Wael Hassaneen Amrendra Miranpuri Amandeep Kaur Jesus N. Sarol Yuan Yang |
| author_sort | Rita Huan-Ting Peng |
| collection | DOAJ |
| description | Abstract Background Stroke is one of the leading causes of death in the USA and is a major cause of serious disability for adults. This randomized crossover study examines the effect of targeted high-definition transcranial direct current transcranial brain stimulation (tDCS) on upper extremity motor recovery in patients in the post-acute phase of stroke recovery. Methods This randomized double-blinded cross-over study includes four intervention arms: anodal, cathodal, and bilateral brain stimulation, as well as a placebo stimulation. Participants receive each intervention in a randomized order, with a 2-week washout period between each intervention. The primary outcome measure is change in Motor Evoked Potential. Secondary outcome measures include the Fugl-Meyer Upper Extremity (FM-UE) score, a subset of FM-UE (A), related to the muscle synergies, and the Modified Ashworth Scale. Discussion We hypothesize that anodal stimulation to the ipsilesional primary motor cortex will increase the excitability of the damaged cortico-spinal tract, reducing the UE flexion synergy and enhancing UE motor function. We further hypothesize that targeted cathodal stimulation to the contralesional premotor cortex will decrease activation of the cortico-reticulospinal tract (CRST) and the expression of the upper extremity (UE) flexion synergy and spasticity. Finally, we hypothesize bilateral stimulation will achieve both results simultaneously. Results from this study could improve understanding of the mechanism behind motor impairment and recovery in stroke and perfect the targeting of tDCS as a potential stroke intervention. With the use of appropriate screening, we anticipate no ethical or safety concerns. We plan to disseminate these research results to journals related to stroke recovery, engineering, and medicine. Trial registration ClinicalTrials.gov NCT05479006 . Registered on 26 July 2022. |
| first_indexed | 2024-03-08T14:13:22Z |
| format | Article |
| id | doaj.art-a3234e57cfd8441e8c713856f468ba7b |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-03-08T14:13:22Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-a3234e57cfd8441e8c713856f468ba7b2024-01-14T12:35:23ZengBMCTrials1745-62152024-01-0125111010.1186/s13063-023-07886-wDetermining the effects of targeted high-definition transcranial direct current stimulation on reducing post-stroke upper limb motor impairments—a randomized cross-over studyRita Huan-Ting Peng0Dorothy He1Shirley A. James2Jordan N. Williamson3Carly Skadden4Sanjiv Jain5Wael Hassaneen6Amrendra Miranpuri7Amandeep Kaur8Jesus N. Sarol9Yuan Yang10Department of Bioengineering, Grainger College of Engineering, University of Illinois Urbana-ChampaignThe University of Oklahoma College of Medicine, University of Oklahoma Health Sciences CenterDepartment of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences CenterDepartment of Bioengineering, Grainger College of Engineering, University of Illinois Urbana-ChampaignCarle Foundation HospitalCarle Foundation HospitalCarle Foundation HospitalCarle Foundation HospitalInterdisciplinary Health Sciences Institute, University of Illinois Urbana-ChampaignInterdisciplinary Health Sciences Institute, University of Illinois Urbana-ChampaignDepartment of Bioengineering, Grainger College of Engineering, University of Illinois Urbana-ChampaignAbstract Background Stroke is one of the leading causes of death in the USA and is a major cause of serious disability for adults. This randomized crossover study examines the effect of targeted high-definition transcranial direct current transcranial brain stimulation (tDCS) on upper extremity motor recovery in patients in the post-acute phase of stroke recovery. Methods This randomized double-blinded cross-over study includes four intervention arms: anodal, cathodal, and bilateral brain stimulation, as well as a placebo stimulation. Participants receive each intervention in a randomized order, with a 2-week washout period between each intervention. The primary outcome measure is change in Motor Evoked Potential. Secondary outcome measures include the Fugl-Meyer Upper Extremity (FM-UE) score, a subset of FM-UE (A), related to the muscle synergies, and the Modified Ashworth Scale. Discussion We hypothesize that anodal stimulation to the ipsilesional primary motor cortex will increase the excitability of the damaged cortico-spinal tract, reducing the UE flexion synergy and enhancing UE motor function. We further hypothesize that targeted cathodal stimulation to the contralesional premotor cortex will decrease activation of the cortico-reticulospinal tract (CRST) and the expression of the upper extremity (UE) flexion synergy and spasticity. Finally, we hypothesize bilateral stimulation will achieve both results simultaneously. Results from this study could improve understanding of the mechanism behind motor impairment and recovery in stroke and perfect the targeting of tDCS as a potential stroke intervention. With the use of appropriate screening, we anticipate no ethical or safety concerns. We plan to disseminate these research results to journals related to stroke recovery, engineering, and medicine. Trial registration ClinicalTrials.gov NCT05479006 . Registered on 26 July 2022.https://doi.org/10.1186/s13063-023-07886-wTargeted high-definition tDCSFlexion synergySpasticityStroke |
| spellingShingle | Rita Huan-Ting Peng Dorothy He Shirley A. James Jordan N. Williamson Carly Skadden Sanjiv Jain Wael Hassaneen Amrendra Miranpuri Amandeep Kaur Jesus N. Sarol Yuan Yang Determining the effects of targeted high-definition transcranial direct current stimulation on reducing post-stroke upper limb motor impairments—a randomized cross-over study Trials Targeted high-definition tDCS Flexion synergy Spasticity Stroke |
| title | Determining the effects of targeted high-definition transcranial direct current stimulation on reducing post-stroke upper limb motor impairments—a randomized cross-over study |
| title_full | Determining the effects of targeted high-definition transcranial direct current stimulation on reducing post-stroke upper limb motor impairments—a randomized cross-over study |
| title_fullStr | Determining the effects of targeted high-definition transcranial direct current stimulation on reducing post-stroke upper limb motor impairments—a randomized cross-over study |
| title_full_unstemmed | Determining the effects of targeted high-definition transcranial direct current stimulation on reducing post-stroke upper limb motor impairments—a randomized cross-over study |
| title_short | Determining the effects of targeted high-definition transcranial direct current stimulation on reducing post-stroke upper limb motor impairments—a randomized cross-over study |
| title_sort | determining the effects of targeted high definition transcranial direct current stimulation on reducing post stroke upper limb motor impairments a randomized cross over study |
| topic | Targeted high-definition tDCS Flexion synergy Spasticity Stroke |
| url | https://doi.org/10.1186/s13063-023-07886-w |
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