Abstract
Background.
Transcranial direct current stimulation (tDCS)(Which one? HD? Cathodal? Anodal?) has been suggested to
improve poststroke recovery. However, its effects on bimanual motor
learning after stroke have not previously been explored.
Objective.
We investigated whether dual-tDCS of the primary motor cortex (M1),
with cathodal and anodal tDCS applied over undamaged and damaged
hemispheres, respectively, improves learning and retention of a new
bimanual cooperative motor skill in stroke patients.
Method.
Twenty-one chronic hemiparetic patients were recruited for a randomized,
double-blinded, cross-over, sham-controlled trial. While receiving real
or sham dual-tDCS, they trained on a bimanual cooperative task called
CIRCUIT. Changes in performance were quantified via bimanual
speed/accuracy trade-off (Bi-SAT) and bimanual coordination factor
(Bi-Co) before, during, and 0, 30, and 60 minutes after dual-tDCS, as
well as one week later to measure retention. A generalization test then
followed, where patients were asked to complete a new CIRCUIT layout.
Results.
The patients were able to learn and retain the bimanual cooperative
skill. However, a general linear mixed model did not detect a
significant difference in retention between the real and sham dual-tDCS
conditions for either Bi-SAT or Bi-Co. Similarly, no difference in
generalization was detected for Bi-SAT or Bi-Co.
Conclusion. The
chronic hemiparetic stroke patients learned and retained the complex
bimanual cooperative task and generalized the newly acquired skills to
other tasks, indicating that bimanual CIRCUIT training is promising as a
neurorehabilitation approach. However, bimanual motor skill learning
was not enhanced by dual-tDCS in these patients.
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