Transcranial direct electrical stimulation for hand function in a stroke patient with severe upper limb paralysis due to lenticulostriate artery occlusion: a case report

Abstract

Background Transcranial direct current stimulation, a therapeutic modality to modulate the excitability of injured and uninjured brain hemispheres in stroke patients, is expected to be effective in treating upper limb paralysis. We describe the use of transcranial direct current stimulation to improve the function and frequency of use of the paralyzed hand of a patient with lenticulostriate artery occlusion. Case presentation A Japanese man in his fifties developed a left internal hindfoot perforator branch infarction owing to lenticulostriate artery occlusion, and presented with severe right upper and lower limb paralysis. Multiple interventions for the paralyzed hand, primarily robot therapy, did not noticeably change his hand function or frequency of use in daily life. Therefore, transcranial direct current stimulation was used in combination with upper limb functional exercises for 20 minutes a day, five times a week, for 6 weeks. Consequently, scores for the hand items of the Fugl–Meyer Assessment of the upper extremities improved, and pain and subluxation around the shoulder joint were reduced. Furthermore, the frequency of use and the quality of movement of the paralyzed hand were improved. Conclusions Upper limb functional training and transcranial direct current stimulation improved the function and frequency of use of the paralyzed hand in a stroke patient with severe upper limb paralysis, suggesting that this combined intervention could effectively improve hand function in patients with severe upper limb paralysis.

Effects of All-Inclusive and Hierarchical Rehabilitation Nursing Model Combined with Acupuncture on Limb Function and Quality of Life in Elderly Patients with Cerebral Infarction during Convalescence

“…Cerebral infarction, also known as cerebral arterial thrombosis, mostly occurs in middle-aged and elderly people, and its main physiological and pathological process is that the patients suffer from ischemic-hypoxic necrosis of local cerebral tissues on the basis of atherosclerosis and successive neurological impairment and deficit [ 1 ]. According to the epidemiological survey data of stroke in 2013, the incidence and mortality of cerebral infarction in China were much higher than the world average level, and its incidence reached up to 42% among Chinese men and 37% among Chinese women [ 2 ]. In 2019, the Lancet further confirmed that the cerebral stroke was the primary cause of death in China from 1990 to 2017 [ 3 ].…”