Effect of Optimized Transcranial Direct Current Stimulation on Motor Cortex Activation in Patients with Sub-acute or Chronic Stroke: a Study Protocol for a Single-blinded Cross-over Randomized Control Trial

Overview

Journal Front Neurosci

Date 2024 Jan 9

PMID 38192515

Authors

Taeyeong Kim

Jhosedyn Carolaym Salazar Fajardo

Hanna Jang

Juwon Lee

Yeonkyung Kim

Gowun Kim

Donghyeon Kim

Affiliations

Soon will be listed here.

Abstract

Introduction: Transcranial direct current stimulation (tDCS) has shown positive but inconsistent results in stroke rehabilitation. This could be attributed to inter-individual variations in brain characteristics and stroke lesions, which limit the use of a single tDCS protocol for all post-stroke patients. Optimizing the electrode location in tDCS for each individual using magnetic resonance imaging (MRI) to generate three-dimensional computer models and calculate the electric field (E-field) induced by tDCS at a specific target point in the primary motor cortex may help reduce these inconsistencies. In stroke rehabilitation, locating the optimal position that generates a high E-field in a target area can influence motor recovery. Therefore, this study was designed to determine the effect of personalized tDCS electrode positions on hand-knob activation in post-stroke patients.

Method: This is a crossover study with a sample size of 50 participants, who will be randomly assigned to one of six groups and will receive one session of either optimized-active, conventional-active, or sham tDCS, with 24 h between sessions. The tDCS parameters will be 1 mA (5 × 5 cm electrodes) for 20 min. The motor-evoked potential (MEP) will be recorded before and after each session over the target area (motor cortex hand-knob) and the MEP hotspot. The MEP amplitude at the target location will be the primary outcome.

Discussion: We hypothesize that the optimized-active tDCS session would show a greater increase in MEP amplitude over the target area in patients with subacute and chronic stroke than conventional and sham tDCS sessions. https://cris.nih.go.kr, identifier KCT0007536.

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