Effect of tDCS on Motor Functions and Brain Activity in Acute Stroke Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Electroencephalography
研究概览
简要总结
This study aims to investigate the effects of anodal tDCS combined with conventional physical therapy for 5 consecutive sessions on motor functions and brain activity in acute stroke patients at immediate and 1-month follow-up.
详细描述
Stroke or cerebrovascular accident is a leading cause of disabilities. Physical therapy is a standard treatment to help motor recovery after stroke. However, disabilities remained in some stroke patients despite intensive training. After stroke, there are changes of cortical excitability and brain activity in both hemispheres. Lesioned hemisphere decreases cortical excitability and increases number of low-frequency brain activity, while the non-lesioned hemisphere increases cortical excitability and increases number of high-frequency brain activity. Transcranial direct current stimulation (tDCS) is a technique which delivers weak direct current through scalp and can be used as an adjunctive treatment. Anodal tDCS can increase cortical excitability and amount of high-frequency brain activity. Increased amount of high-frequency brain activity in the lesioned hemisphere can indicate better recovery of stroke. Meta-analysis has reported the benefits of anodal tDCS for motor recovery in stroke patients. However, only few studies have investigated tDCS effects in acute phase of stroke which is a crucial time for enhancing motor recovery. This study aims to investigate the effects of anodal- and cathodal tDCS combined with conventional physical therapy for 5 consecutive sessions on motor functions and brain activity in acute stroke patients at immediate and 1-month follow-up. Participants will be randomly assigned into 2 groups (sham-, and anodal tDCS). Participants in the anodal group will receive 1.5 mA tDCS for 20 minutes before physical therapy programs for 5 consecutive sessions, while the sham group will receive sham tDCS with physical therapy. Brain activity by electroencephalography and motor performances by Fugl-Meyer Assessment and Wolf Motor Function Test will be evaluated at baseline, post-intervention (day 5), and follow-up at 1 month. We hypothesize that anodal tDCS combined with physical therapy for 5 consecutive days can immediately increase number of high-frequency brain activity and improve motor functions and this effect will last for a month compared to the sham group.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Treatment
- 盲法
- Triple (Participant, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age between 18-75 years old
- •First-ever acute ischemic stroke of anterior circulation system (anterior cerebral artery or middle cerebral artery territory)
- •Stroke onset from 2-10 days
- •Having a stable medical condition
- •Alert of consciousness
- •Able to follow commands
- •Modified Rankin Scale (mRS) ≤ 4
排除标准
- •Hemorrhagic stroke
- •Recurrent stroke
- •Presence of other neurological disorders such as unilateral neglect
- •Presence of metal implantation, intracranial shunt, cochlear implantation or cardiac pacemakers
- •Presence of opened wound or infectious wound around scalp
- •History of epilepsy or any neurological antecedent or unstable condition which can lead to seizure
- •Body Mass Index (BMI) > 30 kg/m2
- •Received hormonal treatment
- •Ischemic heart disease and peripheral vascular ischemia
- •Last stage of kidney disease and liver disease
研究组 & 干预措施
Anodal-tDCS & PT
Anodal transcranial direct current stimulation (tDCS) will be applied for 20 mins before conventional physical therapy (about 1 hours). Anodal on the motor area (M1) of affected hemisphere, Cathodal on the supraorbital area of unaffected hemisphere.
Current intensity is fixed at 1.5 mA and current will flow continuously. Physical therapist will give an intervention program base on the same basic conventional physical therapy treatment. The scope of intervention is administered to improve motor functions and brain activity.
干预措施: Transcranial direct current stimulation (Device)
Sham-tDCS & PT
Anodal transcranial direct current stimulation (tDCS) will be applied for 20 mins before conventional physical therapy (about 1 hours). Anodal on the motor area of affected hemisphere, Cathodal on the supraorbital area of affected hemisphere. Physical therapist will give an intervention program base on the same basic conventional physical therapy treatment. The scope of intervention is administered to improve motor functions and brain activity.
干预措施: Transcranial direct current stimulation (Device)
结局指标
主要结局
Electroencephalography
时间窗: 10 minutes
Brain activity will be recorded during eyes open (5 minutes) follow by eyes close (5 minutes).
次要结局
- Fugl-Meyer Assessment(20 minutes)