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Title: | The effects of transcranial direct current stimulation on upper-limb function post-stroke: a meta-analysis of multiple-session studies | Authors: | VAN HOORNWEDER, Sybren Vanderzande, Laurens Bloemers, Eva VERSTRAELEN, Stefanie DEPESTELE, Siel CUYPERS, Koen VAN DUN, Kim STROUWEN, Carolien MEESEN, Raf |
Issue Date: | 2021 | Publisher: | ELSEVIER IRELAND LTD | Source: | CLINICAL NEUROPHYSIOLOGY, 132(8), p. 1897-1918 | Abstract: | Objective To systematically review how patient characteristics and/or transcranial direct current stimulation (tDCS) parameters influence tDCS effectiveness in respect to upper limb function post-stroke. Methods Three electronic databases were searched for sham-controlled randomised trials using the Fugl-Meyer Assessment for upper extremity as outcome measure. A meta-analysis and nine subgroup-analyses were performed to identify which tDCS parameters yielded the greatest impact on upper limb function recovery in stroke patients. Results Eighteen high-quality studies (507 patients) were included. tDCS applied in a chronic stage yields greater results than tDCS applied in a (sub)acute stage. Additionally, patients with low baseline upper limb impairments seem to benefit more from tDCS than those with high baseline impairments. Regarding tDCS configuration, all stimulation types led to a significant improvement, but only tDCS applied during therapy, and not before therapy, yielded significant results. A positive dose-response relationship was identified for current/charge density and stimulation duration, but not for number of sessions. Conclusion Our results demonstrate that tDCS improves upper limb function post-stroke. However, its effectiveness depends on numerous factors. Especially chronic stroke patients improved, which is promising as they are typically least amenable to recovery. Significance The current work highlights the importance of several patient-related and protocol-related factors regarding tDCS effectiveness. | Keywords: | Transcranial direct current stimulation;Stroke;Upper limb;Motor recovery;Review;Meta-analysis | Document URI: | http://hdl.handle.net/1942/34282 | ISSN: | 1388-2457 | e-ISSN: | 1872-8952 | DOI: | 10.1016/j.clinph.2021.05.015 | ISI #: | 000674175200019 | Datasets of the publication: | 10.1016/j.clinph.2021.05.015 | Rights: | 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2022 |
Appears in Collections: | Research publications |
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The effects of transcranial direct current stimulation on upper-limb function post-stroke_ A meta-analysis of multiple-session studies.pdf Restricted Access | Published version | 7.33 MB | Adobe PDF | View/Open Request a copy |
CLINPH-D-21-14231_R1 (1).pdf | Peer-reviewed author version | 3.31 MB | Adobe PDF | View/Open |
1-s2.0-S1388245721006003-main (1).pdf | Non Peer-reviewed author version | 5.33 MB | Adobe PDF | View/Open |
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