Article

Neurophysiological and computer modelling studies have shown that electrode
montage is a critical parameter to determine the neuromodulatory effects of
transcranial direct current stimulation (tDCS). We tested these results
clinically by systematically investigating optimal tDCS electrode montage in
stroke. Ten patients received in a counterbalanced and randomised order the
following conditions of stimulation (i) anodal stimulation of affected M1
(primary motor cortex) and cathodal stimulation of unaffected M1 ('bilateral
tDCS'); (ii) anodal stimulation of affected M1 and cathodal stimulation of
contralateral supraorbital area ('anodal tDCS'); (iii) cathodal stimulation of
unaffected M1 and anodal stimulation of contralateral supraorbital area
('cathodal tDCS'); (iv) anodal stimulation of affected M1 and cathodal
stimulation of contralateral deltoid muscle ('extra-cephalic tDCS') and (v) sham
stimulation. We used the Jebsen-Taylor Test (JTT) as a widely accepted measure of
upper limb function. Bilateral tDCS, anodal tDCS and cathodal tDCS were shown to
be associated with significant improvements on the JTT. Placing the reference
electrode in an extracephalic position and use of sham stimulation did not induce
any significant effects. This small sham controlled cross-over clinical trial is
important to provide additional data on the clinical effects of tDCS in stroke
and for planning and designing future large tDCS trials in patients with stroke.

Langue : ANGLAIS