A meta-analysis of the efficacy of anodal transcranial direct current stimulation for upper limb motor recovery in stroke survivors.

STUDY DESIGN

Systematic review and meta-analysis.

INTRODUCTION

Prior reviews on the effects of anodal transcranial direct current stimulation (a-tDCS) have shown the effectiveness of a-tDCS on corticomotor excitability and motor function in healthy individuals but nonsignificant effect in subjects with stroke.

PURPOSE

To summarize and evaluate the evidence for the efficacy of a-tDCS in the treatment of upper limb motor impairment after stroke.

METHODS

A meta-analysis of randomized controlled trials that compared a-tDCS with placebo and change from baseline.

RESULTS

A pooled analysis showed a significant increase in scores in favor of a-tDCS (standard mean difference [SMD]=0.40, 95% confidence interval [CI]=0.10-0.70, p=0.010, compared with baseline). A similar effect was observed between a-tDCS and sham (SMD=0.49, 95% CI=0.18-0.81, p=0.005).

CONCLUSION

This meta-analysis of eight randomized placebo-controlled trials provides further evidence that a-tDCS may benefit motor function of the paretic upper limb in patients suffering from chronic stroke.

LEVEL OF EVIDENCE

Level 1a.