High-Definition Transcranial Direct Current with Electrical Theta Burst on Post-Stroke Motor Rehabilitation: A Pilot Randomized Controlled Trial

How many hospitals have both of these and know how to work them together? In simple words; Where the fuck is the protocol so your hospital will do it right the first time?

High-Definition Transcranial Direct Current with Electrical Theta Burst on Post-Stroke Motor Rehabilitation: A Pilot Randomized Controlled Trial

Yi-Jing Huang, PhD, Shun-Min Wang, PhD, […], Chieh Chen, MD, Chien-An Chen, MS, Chun-Wei Wu, PhD, Jia-Jin Chen, PhD, Chih-Wei Peng, PhD, Che-Wei Lin, PhD, Shih-Wei Huang, PhD, and Shih-Ching Chen, PhD https://orcid.org/0000-0002-8630-1271 csc@tmu.edu.tw, +7 -7View all authors and affiliations

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https://doi.org/10.1177/15459683221121751

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Abstract

Background:

High-definition transcranial electrical theta burst superimposing direct current stimulation (HD-tDCS-eTBS) not only incorporates the therapeutic advantages of tDCS and TBS but enhances stimulation focality and practicality. However, the applicability of this innovative neuromodulatory device in post-stroke rehabilitation remains uncertain.

Objective:

This study aimed to assess the efficacy and safety of the HD-tDCS-eTBS on upper extremity (UE) motor function in patients with chronic stroke.

Methods:

A patient-blinded, randomized controlled study was conducted. Twenty-four participants were randomly assigned into either the active HD-tDCS-eTBS group or sham HD-tDCS-eTBS group. Both groups received 20 minutes of active/sham HD-tDCS-eTBS combined with 30 minutes of conventional UE rehabilitation each time, 3 times a week for 4 weeks. Outcome measures including the Fugl-Meyer Assessment of Upper Extremity, Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, Finger-Nose Test, and Modified Ashworth Scale were assessed before and immediately after the intervention period.

Results:

Spasticity of shoulder adductor (P = .05), elbow extensor (P = .04), and thumb flexor (P < .01) were significantly reduced in the active HD-tDCS-eTBS group versus the sham group. Nonsignificant trends in the improvements of most other outcome measures were in favor of the active HD-tDCS-eTBS group with moderate to large effect sizes (P = .06–.26, η_p² = 0.06–0.16). No severe adverse events except for slight skin redness under the stimulus electrode was detected after the HD-tDCS-eTBS.

Conclusions:

Our findings support that HD-tDCS-eTBS is safe and has therapeutic potential for post-stroke UE motor rehabilitation.

Trial registration:

ClinicalTrials.gov (ID: NCT04278105).