Bhasin Ashu, Iqbal Gulafshan, Sharma Rahul, Kumaran Senthil S, Vy Vishnu, Srivastava Padma V
Neurology, All India Institute of Medical Sciences, New Delhi, IND.
Nuclear Magnetic Resonance (NMR), All India Institute of Medical Sciences, New Delhi, IND.
Cureus. 2025 Jul 23;17(7):e88586. doi: 10.7759/cureus.88586. eCollection 2025 Jul.
Background Transcranial direct current stimulation (tDCS) has attracted attention among researchers as it has significant neurorehabilitative effects post-stroke. The purpose of the study was to investigate the safety, feasibility, and probable efficacy of bicephalic tDCS in improving hand function after stroke. Methods We conducted a prospective non-randomized controlled study involving two groups of participants with chronic stroke. Participants were allocated to real tDCS (r-tDCS) and age-matched controls to sham tDCS (s-tDCS). The treatment session was for 20 minutes, along with physiotherapy for four weeks. The primary outcome measure was the Fugl-Meyer assessment (FMA), while secondary outcomes were the Action Research Arm Test (ARAT), modified Barthel Index (mBI), Brunnstrom stage, and functional magnetic resonance imaging (fMRI) measures. All the assessments were done at baseline, four weeks, and three months. Results Ninety-five patients were recruited. No side effects were reported. FMA (d=0.75; 95% CI: 1.17 to 0.34; p=0.03) and mBI (d=0.70; 95% CI: 1.11 to 0.19; p=0.04) showed significant improvement at three months, although mean FMA was higher in r-tDCS than s-tDCS at four weeks. ARAT and Medical Research Council (MRC) were statistically insignificant between the groups at all time points. A mild increase in the cluster counts of premotor and primary motor cortex (Brodmann area (BA) 4 and BA 6) in group 1 was observed at four weeks and three months. Conclusion The novel intervention tDCS was safe and compliant among subjects but failed to report a significant efficacy between the two groups. A greater neural activation of ipsilesional primary motor regions (BA 4 and BA 6) and a weak positive correlation of FMA with laterality index (LI) were observed in the r-tDCS group than the s-tDCS group which may have led to improved hand function.
经颅直流电刺激（tDCS）因其对中风后具有显著的神经康复作用而受到研究人员的关注。本研究的目的是探讨双侧tDCS改善中风后手功能的安全性、可行性和可能的疗效。方法：我们进行了一项前瞻性非随机对照研究，纳入两组慢性中风患者。参与者被分配到真正的tDCS（r-tDCS）组和年龄匹配的假tDCS（s-tDCS）对照组。治疗疗程为20分钟，同时进行四周的物理治疗。主要结局指标是Fugl-Meyer评估（FMA），次要结局指标是行动研究臂测试（ARAT）、改良Barthel指数（mBI）、Brunnstrom分期和功能磁共振成像（fMRI）测量。所有评估均在基线、四周和三个月时进行。结果：招募了95名患者。未报告有副作用。FMA（d=0.75；95%CI：1.17至0.34；p=0.03）和mBI（d=0.70；95%CI：1.11至0.19；p=0.04）在三个月时显示出显著改善，尽管在四周时r-tDCS组的平均FMA高于s-tDCS组。在所有时间点，两组之间的ARAT和医学研究委员会（MRC）在统计学上无显著差异。在四周和三个月时，观察到第1组运动前区和初级运动皮层（Brodmann区（BA）4和BA 6）的簇计数轻度增加。结论：新型干预措施tDCS在受试者中是安全且依从性良好的，但两组之间未报告有显著疗效。与s-tDCS组相比，r-tDCS组观察到患侧初级运动区（BA 4和BA 6）有更大的神经激活，且FMA与偏侧指数（LI）呈弱正相关，这可能导致了手功能的改善。
