The Efficacy of Transcranial Direct Current Stimulation (tDCS) on Upper Extremity Motor Function After Stroke: a Systematic Review and Comparative Meta-analysis of Different Stimulation Polarities.

Abstract

BACKGROUND:

The efficacy of transcranial direct current stimulation (tDCS) has been extensively studied. The cathodic (c-tDCS), anodic (a-tDCS), and bihemispheric stimulation have demonstrated efficacy in the management of the paretic upper extremity (UE) after stroke, but it has not been determined which stimulation polarity has, so far, shown the best results.

OBJECTIVE:

To evaluate the available evidence to determine which tDCS polarity has the best results in improving UE motor function after stroke.

METHODS:

PubMed, PEDro, Web of Science, EMBASE and SCOPUS databases were searched. Different Medical Subject Headings (MeSH) terms were combined for the search strategy, to cover all studies that performed a comparison between different tDCS configurations focused on UE motor rehabilitation in people with lived experience of stroke.

RESULTS:

15 studies remained for qualitative analysis and 12 for quantitative analysis. Non-significant differences with a 95% confidence interval were obtained for c-tDCS versus a-tDCS (g=.10, 95% CI= -.13; .33, P= .39, N= 292), for a-tDCS versus bihemispheric (g=.02, 95% CI= -.46; .42, P= .93, N= 81), and for c-tDCS versus bihemispheric (g=.09, 95% CI= -.84; .66, P= .73, N= 100;). No significant differences between the subgroups of the meta-analysis were found.

CONCLUSIONS:

The results of the present meta-analysis showed no evidence that a stimulation polarity is superior to the others in the rehabilitation of UL motor function after stroke. A non-significant improvement trend was observed towards c-tDCS compared to a-tDCS.

• Authors: Víctor Navarro-López, Manuel Del-Valle-Gratacós, María Carratalá-Tejada, Alicia Cuesta Gómez, Diego Fernández Vázquez, Francisco Molina-Rueda
• Journal: PM & R : the journal of injury, function, and rehabilitation (PM R) (Oct 24 2023) ISSN: 1934-1563 [Electronic] United States
• PMID: 37873699 (Publication Type: Journal Article, Review)
• Copyright: This article is protected by copyright. All rights reserved.