Article

It is thought that following a stroke the contralesional motor region
exerts an undue inhibitory influence on the lesional motor region which might limit recovery. Pilot studies have shown that suppressing the contralesional
motor region with cathodal transcranial Direct Current Stimulation (tDCS) can
induce a short lasting functional benefit; greater and longer lasting effects
might be achieved with combining tDCS with simultaneous occupational therapy (OT)
and applying this intervention for multiple sessions.
METHODS: We carried out a
randomized, double blind, sham controlled study of chronic stroke patients
receiving either 5 consecutive days of cathodal tDCS (for 30 minutes) applied to
the contralesional motor region and simultaneous OT, or sham tDCS+OT. RESULTS: we
showed that cathodal tDCS+OT resulted in significantly more improvement in
Range-Of-Motion in multiple joints of the paretic upper extremity and in the
Upper-Extremity Fugl-Meyer scores than sham tDCS+OT,
and that the effects lasted
at least one week post-stimulation. Improvement in motor outcome scores was
correlated with decrease in fMRI activation in the contralesional motor region
exposed to cathodal stimulation. CONCLUSIONS: This suggests that cathodal tDCS
combined with OT leads to significant motor improvement after stroke due to a
decrease in the inhibitory effect that the contralesional hemisphere exerts onto the lesional hemisphere.

Langue : ANGLAIS