Bihemispheric Transcranial Direct Current Stimulation Over Primary Motor Cortex Potentiates Improvement of Neurological but not Upper Limb Motor Functions in Ischemic Stroke Patients Treated With Routine Physical Therapy: A Randomized, Double-Blind, Sham-Controlled Trial.

Objectives: We investigated the therapeutic effect of transcranial direct current stimulation combined with routine physiotherapy on the neurological and upper limb motor function in ischemic stroke patients with hemiplegia.

Methods: In a randomized double-blind controlled trial study, 52 eligible stroke patients were assigned to real transcranial direct current stimulation receiving bihemispheric electrical current with 1.5 mA for 30 mins over the primary motor cortex, and sham transcranial direct current stimulation with a current intensity of 0.5 mA for 30 secs. Both groups received routine physiotherapy, 5 sessions per week for 2 wks. The National Institute of Health Stroke Scale and the Medical Research Council Scale for Muscle Strength were used to assess the neurological and upper limb motor functions, respectively.

Results: Both therapeutic approaches begot a significant improvement in upper limb motor function and neurological impairment at the last session of therapy and follow-up study. However, the treatment-induced neurological amelioration at the last session of therapy in real transcranial direct current stimulation was significantly more than sham, especially in those identified as female and under 60 yrs old.

Conclusions: A gender and age-specific protocol of real transcranial direct current stimulation combined with routine physiotherapy might be beneficial to improve neurological impairment but not upper limb motor dysfunction after stroke.