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Transcranial Direct Current Stimulation in Stroke Rehabilitation: Present and Future

  • Oluwole O. AwosikaEmail author
  • Leonardo G. Cohen
Chapter

Abstract

Stroke is the leading cause of severe lasting adult disability around the world. Despite efforts to standardize post-stroke care and rehabilitation a significant percentage of patients remain permanently disabled. Life expectancy after stroke is on the rise in part due to improvements in health care. Hence, it is necessary to develop cost efficient ways to improve the beneficial effects of customary neurorehabilitative interventions (i.e., physical and occupational therapy) on motor and cognitive function after stroke. Over the years, transcranial direct current stimulation has emerged as a possible neuromodulatory tool adjuvant to standard neurorehabilitative therapy. Recent meta-analysis suggested moderate beneficial effects of tDCS on motor function after stroke. However, results from clinical trials have not been conclusive, suggesting the need to understand mechanisms underlying tDCS effects, including optimal stimulation protocols, timing, duration and magnitude of stimulation, and the identification of patient groups more amenable to tDCS effects. Here we discuss study results (organized by functional deficits) to date and discuss critically available evidence. Future studies could benefit from tighter experimental designs, more detailed description of methodologies, preregistration when appropriate and enhanced replication efforts.

Keywords

Neurorehabilitation Stroke tDCS Neuromodulation Plasticity Motor recovery Hemiparesis Hemi-neglect Aphasia Dysphagia Gait 

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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Human Cortical Physiology and Stroke Neurorehabilitation SectionNational Institutes of HealthBethesdaUSA
  2. 2.Department of Neurology and Rehabilitation MedicineUniversity of Cincinnati College of MedicineCincinnatiUSA

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