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Practical Guide to Transcranial Direct Current Stimulation pp 509–539Cite as

Transcranial Direct Current Stimulation in Stroke Rehabilitation: Present and Future

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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Fig. 17.1
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Authors and Affiliations

  1. Human Cortical Physiology and Stroke Neurorehabilitation Section, National Institutes of Health, Bethesda, MD, USA

    Oluwole O. Awosika & Leonardo G. Cohen

  2. Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Oluwole O. Awosika

Authors
  1. Oluwole O. Awosika
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  2. Leonardo G. Cohen
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Correspondence to Oluwole O. Awosika .

Editor information

Editors and Affiliations

  1. MJHS Institute for Innovation in Palliative Care, New York, NY, USA

    Ph.D. Helena Knotkova

  2. Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany

    MD Michael A. Nitsche

  3. Department of Biomedical Engineering, The City College of New York, New York, NY, USA

    Ph.D. Marom Bikson

  4. Center for Cognitive Aging and Memory (CAM), McKnight Brain Institute, Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA

    Ph.D. Adam J. Woods

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Awosika, O.O., Cohen, L.G. (2019). Transcranial Direct Current Stimulation in Stroke Rehabilitation: Present and Future. In: Knotkova, H., Nitsche, M., Bikson, M., Woods, A. (eds) Practical Guide to Transcranial Direct Current Stimulation. Springer, Cham. https://doi.org/10.1007/978-3-319-95948-1_17

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