Transcranial Direct Current Stimulation for Post-Stroke Motor Impairment

This trial aims to determine if a non-invasive brain stimulation technique, transcranial direct current stimulation (tDCS), can improve recovery for stroke patients with arm movement problems. Participants will receive either real or sham (fake) brain stimulation, combined with modified constraint-induced movement therapy (mCIMT), which encourages use of the affected arm. This trial targets individuals who have experienced a stroke affecting one side of the body and still struggle significantly with arm movement. The goal is to assess whether this combined approach can enhance motor function and improve performance in everyday tasks. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could advance stroke recovery therapies.

The trial information does not specify whether you need to stop taking your current medications. However, if you are currently undergoing anti-malarial treatment, you must discontinue it before participating.

A previous study showed that high-definition transcranial direct current stimulation (HD-tDCS) was safe and well-tolerated in older adults, with no serious side effects. This non-invasive brain stimulation method uses mild electrical currents to improve brain function and has been used in stroke recovery without major issues. Some minor side effects, such as tingling or itching on the scalp, have been reported but are usually mild and temporary.

Modified constraint-induced movement therapy (mCIMT) is another part of the treatment and is also considered safe for stroke recovery. This therapy involves using the weaker arm more often, which can help improve its function over time. Studies have shown that mCIMT can be effective without causing harm.

Researchers are excited about the use of transcranial direct current stimulation (tDCS) combined with modified constraint-induced movement therapy (mCIMT) for treating post-stroke motor impairment because it introduces a unique approach to rehabilitation. Unlike traditional therapies that primarily involve physical exercises and repetitive tasks, tDCS offers a non-invasive way to stimulate brain activity and enhance neural plasticity. This high-definition brain stimulation, especially when optimally targeted, might enhance recovery by promoting the brain's natural ability to rewire itself. The combination with mCIMT, which already encourages movement in the affected limbs by restricting the unaffected ones, could potentially lead to faster and more effective improvements in motor function.

This trial will compare the effects of optimal targeted high-definition transcranial direct current stimulation (HD-tDCS) combined with modified constraint-induced movement therapy (mCIMT) to a sham HD-tDCS combined with mCIMT. Studies have shown that HD-tDCS can improve movement after a stroke. In one study, six out of nine patients experienced better arm and hand movement following HD-tDCS treatment. Another study found that combining HD-tDCS with rehabilitation exercises further aids recovery. This non-invasive method helps the brain adapt and heal. While the results are promising, individual responses can vary, and more research is needed to confirm these findings.¹³⁵⁶⁷