Comparison of Repetitive Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation on Upper Limb Recovery Among Patients With Recent Stroke

Abstract

Objective To compare the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on upper limb function recovery among patients who recently had stroke.Methods Subjects with recent stroke (within 1 month) were randomized to rTMS (n=25) and tDCS (n=26) applied over the non-lesioned hemisphere for three sessions per week, followed by tailored upper limb rehabilitation training for a total of 2 weeks. The primary outcomes were changes in the Motor Assessment Scale (MAS), Fugl-Meyer arm score test, Nine-Hole Peg Test (9HPT), hand grip strength, and modified Barthel Index at weeks 2 and 4. Both therapists responsible for training and assessment were blinded to the intervention allocated.Results There was an improvement in all the motor performance scales among both groups (p<0.001). These improvements persisted at discharge. However, there was no significant difference in any of the assessment scales between the two groups. The rTMS group showed a statistically non-significant greater improvement in MAS, 9HPT, and handgrip strength than the tDCS group.Conclusion Both interventions produce a statistically significant improvement in upper limb function. There was no statistically significant difference between the two intervention methods with respect to motor performance. It is suggested that a larger study may help to clarify the superiority of either methods.

Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery

“…Stroke is a leading cause of death and disability in our society, primarily as specific therapeutic rehabilitation strategies remain limited. 1-4 The potential of novel non-invasive brain stimulation methods, for example, transcranial direct current stimulation (tDCS), to promote recovery in human patients has been investigated for decades and is widely considered promising after stroke and other conditions, 5-14 although large randomized clinical trials are lacking. Furthermore, the neurobiological mechanisms underlying non-invasive brain stimulation remain poorly understood, and standardized protocols have not been established.…”

Effect of Cathodal Transcranial Direct Current Stimulation for Lower Limb Subacute Stroke Rehabilitation

“…Third, we did not perform any neurophysiological assessment and imaging evaluation, such as motor-evoked potential MEP recordings, which could provide a measure of cortical motor excitability; functional neurological changes were analyzed by functional magnetic resonance. Fourth, the present study lacks a comparison with anodal tDCS and other brain stimulation techniques (TMS) [ 37 ] which can be a helpful noninvasive tool to evaluate cortical excitability, neural plasticity, and underlying transmission pathways. TMS studies have shown enhanced cortical excitability and plasticity in VCI patients, which may be considered as an adaptive response to disease progression [ 38 ].…”

Noninvasive Brain Stimulation for Cancer Pain Management in Nonbrain Malignancy: A Meta-Analysis

“…Moreover, a recent head-to-head randomized trial showed that rTMS was superior to tDCS in improving neuropathic pain [51,52]. Te advantage of rTMS compared to tDCS and CES results from a higher intensity with a more focused electrical feld [53]. Te electric feld produced in the brain tissue is proportional to the current intensity generated by the NIBS device [54].…”