My conclusion is that since you didn't even write up a tentative stroke protocol everything here is useless for survivors. Didn't even tell us why anodal tDCS was used.
Stimulation targeting higher motor areas in stroke rehabilitation: A proof-of-concept, randomized, double-blinded placebo- controlled study of effectiveness and underlying mechanisms HHS Public Access
David A. Cunninghama,b, Nicole Varnerina, Andre Machadoc, Corin Bonnetta, Daniel Janinia, Sarah Roellea, Kelsey Potter-Bakera, Vishwanath Sankarasubramaniana, Xiaofeng Wangd, Guang Yuee, and Ela B. Plowa,c,f,*aDepartment of Biomedical Engineering, Lerner Research Inst., Cleveland Clinic, Cleveland, OH, USAb School of Biomedical Sciences, Kent State University, Kent, OH, USAc Center for Neurological Restoration, Neurosurgery, Neurological Inst., Cleveland Clinic, Cleveland, OH, USA d Department of Quantitative Health Sciences, Cleveland Clinic, OH, USA e Human Performance & Engineering Laboratory, Kessler Foundation Research Center, West Orange, NJ, USA f Department of Physical Medicine & Rehab, Neurological Inst., Cleveland Clinic, Cleveland, OH,Abstract Purpose
To demonstrate, in a proof-of-concept study, whether potentiating ipsilesional higher motor areas (premotor cortex and supplementary motor area) augments and accelerates recovery associated with constraint induced movement.
Methods
In a randomized, double-blinded pilot clinical study, 12 patients with chronic stroke were assigned to receive anodal transcranial direct current stimulation (tDCS) ( n = 6) or sham ( n = 6) to the ipsilesional higher motor areas during constraint-induced movement therapy. We assessed functional and neurophysiologic outcomes before and after 5 weeks of therapy.
Results
Only patients receiving tDCS demonstrated gains in function and dexterity. Gains were accompanied by an increase in excitability of the contralesional rather than the ipsilesional hemisphere. Conclusions— Our proof-of-concept study provides early evidence that stimulating higher motor areas can help recruit the contralesional hemisphere in an adaptive role in cases of greater ipsilesional injury. Whether this early evidence of promise translates to remarkable gains in functional recovery compared to existing approaches of stimulation remains to be confirmed in
large-scale clinical studies that can reasonably dissociate stimulation of higher motor areas from that of the traditional primary motor cortices
* Corresponding author: Ela B. Plow, PhD, PT, Assistant Staff, Biomedical Engineering, 9500 Euclid Ave, ND20, Cleveland Clinic, Cleveland, 44195 OH, USA. Tel.: +1 216 445 4589; Fax: +1 216 444 9198; plowe2@ccf.org. HHS Public Access Author manuscript
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