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Takahashi MTC, Balardin JB, Bazán PR, Boasquevisque DDS, Amaro E, Conforto AB. Effect of transcranial direct current stimulation in the initial weeks post-stroke: a pilot randomized study. EINSTEIN-SAO PAULO 2024; 22:eAO0450. [PMID: 38922218 PMCID: PMC11196089 DOI: 10.31744/einstein_journal/2024ao0450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 09/18/2023] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE This study aimed at assessing the alterations in upper limb motor impairment and connectivity between motor areas following the post-stroke delivery of cathodal transcranial direct current stimulation sessions. METHODS Modifications in the Fugl-Meyer Assessment scores, connectivity between the primary motor cortex of the unaffected and affected hemispheres, and between the primary motor and premotor cortices of the unaffected hemisphere were compared prior to and following six sessions of cathodal transcranial direct current stimulation application in 13 patients (active = 6; sham = 7); this modality targets the primary motor cortex of the unaffected hemisphere early after a stroke. RESULTS Clinically relevant distinctions in Fugl-Meyer Assessment scores (≥9 points) were observed more frequently in the Sham Group than in the Active Group. Between-group differences in the alterations in Fugl-Meyer Assessment scores were not statistically significant (Mann-Whitney test, p=0.133). ROI-to-ROI correlations between the primary motor cortices of the affected and unaffected hemispheres post-therapeutically increased in 5/6 and 2/7 participants in the Active and Sham Groups, respectively. Between-group differences in modifications in connectivity between the aforementioned areas were not statistically significant. Motor performance enhancements were more frequent in the Sham Group compared to the Active Group. CONCLUSION The results of this hypothesis-generating investigation suggest that heightened connectivity may not translate into early clinical benefits following a stroke and will be crucial in designing larger cohort studies to explore mechanisms underlying the impacts of this intervention. ClinicalTrials.gov Identifier: NCT02455427.
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Affiliation(s)
- Marcela Tengler Carvalho Takahashi
- Hospital Municipal da Vila Santa Catarina Dr. Gilson Cássia Marques de CarvalhoHospital Israelita Albert EinsteinSão PauloSPBrazilHospital Municipal da Vila Santa Catarina Dr. Gilson Cássia Marques de Carvalho ; Hospital Israelita Albert Einstein,São Paulo, SP, Brazil.
| | - Joana Bisol Balardin
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Paulo Rodrigo Bazán
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Danielle de Sá Boasquevisque
- Division of NeurologyPopulation Health Research InstitutMcMaster UniversityHamiltonOntarioCanada Division of Neurology, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
| | - Edson Amaro
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Adriana Bastos Conforto
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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Yang CL, Connell LA, Eng JJ. Evaluating the Dissemination and Implementation Impact of a Rehabilitation Intervention: The Graded Repetitive Arm Supplementary Program (GRASP). Physiother Can 2023; 75:105-117. [PMID: 37736384 PMCID: PMC10510554 DOI: 10.3138/ptc-2022-0117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 09/23/2023]
Abstract
Purpose To evaluate the dissemination and implementation impacts of a rehabilitation intervention. Methods Systematic evaluation of data sources including academic publishing metrics, publications, and surveys was used to describe the dissemination and implementation impact of the graded repetitive arm supplementary program (GRASP). Three categories in the Payback Framework were evaluated: knowledge production and dissemination, benefits to future research and research use, and real-world uptake and implementation. Results In the Knowledge production and dissemination category, seven publications, authored by the GRASP research team, were associated with the GRASP, and there were approximately 17,000 download counts of GRASP manuals from the website from 120 countries. In the Benefits to future research and research use category, 15 studies and 8 registered clinical trials, authored by researchers outside of the GRASP team, have used GRASP as an intervention. In the real-world uptake and implementation category, GRASP has informed recommendations in 2 clinical guidelines and 20 review papers, and had high implementation uptake (e.g., 35% [53/154] of UK therapists surveyed had used GRASP; 95% [649/681] who downloaded GRASP had used it). More than 75% of those who had used GRASP identified that GRASP provides more intensity in upper extremity rehabilitation, is evidence-based and easy to implement, and the equipment and manual are easy to obtain. Conclusion The Payback Framework is useful to evaluate the dissemination and implementation impacts of a rehabilitation intervention. GRASP has been implemented extensively in clinical practice and community in a relatively short time since it has been developed.
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Affiliation(s)
- Chieh-ling Yang
- From the:
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Louise A. Connell
- School of Sport & Health Sciences, University of Central Lancashire, Preston, United Kingdom
- East Lancashire Hospitals NHS Trust, Burnley, United Kingdom
| | - Janice J. Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada
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Salazar CA, Feng W, Bonilha L, Kautz S, Jensen JH, George MS, Rowland NC. Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward? J Clin Med 2023; 12:2601. [PMID: 37048684 PMCID: PMC10094806 DOI: 10.3390/jcm12072601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
During rehabilitation, a large proportion of stroke patients either plateau or begin to lose motor skills. By priming the motor system, transcranial direct current stimulation (tDCS) is a promising clinical adjunct that could augment the gains acquired during therapy sessions. However, the extent to which patients show improvements following tDCS is highly variable. This variability may be due to heterogeneity in regions of cortical infarct, descending motor tract injury, and/or connectivity changes, all factors that require neuroimaging for precise quantification and that affect the actual amount and location of current delivery. If the relationship between these factors and tDCS efficacy were clarified, recovery from stroke using tDCS might be become more predictable. This review provides a comprehensive summary and timeline of the development of tDCS for stroke from the viewpoint of neuroimaging. Both animal and human studies that have explored detailed aspects of anatomy, connectivity, and brain activation dynamics relevant to tDCS are discussed. Selected computational works are also included to demonstrate how sophisticated strategies for reducing variable effects of tDCS, including electric field modeling, are moving the field ever closer towards the goal of personalizing tDCS for each individual. Finally, larger and more comprehensive randomized controlled trials involving tDCS for chronic stroke recovery are underway that likely will shed light on how specific tDCS parameters, such as dose, affect stroke outcomes. The success of these collective efforts will determine whether tDCS for chronic stroke gains regulatory approval and becomes clinical practice in the future.
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Affiliation(s)
- Claudia A. Salazar
- Department of Neurosurgery, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
- Center for Biomedical Imaging, University of South Carolina, Columbia, SC 29208, USA
- Department of Neuroscience, College of Graduate Studies, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Wuwei Feng
- Department of Neurology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Leonardo Bonilha
- Department of Neurology, College of Medicine, Emory University, Atlanta, GA 30322, USA
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Steven Kautz
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA
| | - Jens H. Jensen
- Center for Biomedical Imaging, University of South Carolina, Columbia, SC 29208, USA
- Department of Neuroscience, College of Graduate Studies, Medical University of South Carolina, Charleston, SC 29425, USA
- Department of Radiology and Radiological Science, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Mark S. George
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Nathan C. Rowland
- Department of Neurosurgery, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
- Center for Biomedical Imaging, University of South Carolina, Columbia, SC 29208, USA
- Department of Neuroscience, College of Graduate Studies, Medical University of South Carolina, Charleston, SC 29425, USA
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA
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Yang K, Xi X, Wang T, Wang J, Kong W, Zhao YB, Zhang Q. Effects of transcranial direct current stimulation on brain network connectivity and complexity in motor imagery. Neurosci Lett 2021; 757:135968. [PMID: 34023412 DOI: 10.1016/j.neulet.2021.135968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/07/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022]
Abstract
Related experiments have shown that transcranial direct current stimulation (tDCS) anodal stimulation of the brain's primary motor cortex (M1) and supplementary motor area (SMA) can improve the motor control and clinical manifestations of stroke patients with aphasia and dyskinesia. In this study, to explore the different effects of tDCS on the M1 and SMA in motor imagery, 35 healthy volunteers participated in a double-blind randomized controlled experiment. Five subjects underwent sham stimulation (control), 15 subjects underwent tDCS anode stimulation of the M1, and the remaining 15 subjects underwent tDCS anode stimulation of the SMA. The electroencephalogram data of the subjects' left- and right-hand motor imagery under different stimulation paradigms were recorded. We used a functional brain network and sample entropy to examine the different complexities and functional connectivities in subjects undergoing sham-tDCS and the two stimulation paradigms. The results show that tDCS anodal stimulation of the SMA produces less obvious differences in the motor preparation phase, while tDCS anodal stimulation of the M1 produces significant differences during the motor imaging task execution phase. The effect of tDCS on the motor area of the brain is significant, especially in the M1.
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Affiliation(s)
- Kangbo Yang
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; Key Laboratory of Brain Machine Collaborative Intelligence of Zhejiang Province, Hangzhou 310018, China
| | - Xugang Xi
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; Key Laboratory of Brain Machine Collaborative Intelligence of Zhejiang Province, Hangzhou 310018, China.
| | - Ting Wang
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; Key Laboratory of Brain Machine Collaborative Intelligence of Zhejiang Province, Hangzhou 310018, China
| | - Junhong Wang
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; Key Laboratory of Brain Machine Collaborative Intelligence of Zhejiang Province, Hangzhou 310018, China
| | - Wanzeng Kong
- Key Laboratory of Brain Machine Collaborative Intelligence of Zhejiang Province, Hangzhou 310018, China
| | - Yun-Bo Zhao
- Department of Automation, University of Science and Technology of China, Hefei, 230026, China
| | - Qizhong Zhang
- School of Automation, Hangzhou Dianzi University, Hangzhou 310018, China; Key Laboratory of Brain Machine Collaborative Intelligence of Zhejiang Province, Hangzhou 310018, China
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Elsner B, Kugler J, Pohl M, Mehrholz J. Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke. Cochrane Database Syst Rev 2020; 11:CD009645. [PMID: 33175411 PMCID: PMC8095012 DOI: 10.1002/14651858.cd009645.pub4] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Stroke is one of the leading causes of disability worldwide. Functional impairment, resulting in poor performance in activities of daily living (ADL) among stroke survivors is common. Current rehabilitation approaches have limited effectiveness in improving ADL performance, function, muscle strength, and cognitive abilities (including spatial neglect) after stroke, with improving cognition being the number one research priority in this field. A possible adjunct to stroke rehabilitation might be non-invasive brain stimulation by transcranial direct current stimulation (tDCS) to modulate cortical excitability, and hence to improve these outcomes in people after stroke. OBJECTIVES To assess the effects of tDCS on ADL, arm and leg function, muscle strength and cognitive abilities (including spatial neglect), dropouts and adverse events in people after stroke. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase and seven other databases in January 2019. In an effort to identify further published, unpublished, and ongoing trials, we also searched trials registers and reference lists, handsearched conference proceedings, and contacted authors and equipment manufacturers. SELECTION CRITERIA This is the update of an existing review. In the previous version of this review, we focused on the effects of tDCS on ADL and function. In this update, we broadened our inclusion criteria to compare any kind of active tDCS for improving ADL, function, muscle strength and cognitive abilities (including spatial neglect) versus any kind of placebo or control intervention. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and risk of bias, extracted data, and applied GRADE criteria. If necessary, we contacted study authors to ask for additional information. We collected information on dropouts and adverse events from the trial reports. MAIN RESULTS We included 67 studies involving a total of 1729 patients after stroke. We also identified 116 ongoing studies. The risk of bias did not differ substantially for different comparisons and outcomes. The majority of participants had ischaemic stroke, with mean age between 43 and 75 years, in the acute, postacute, and chronic phase after stroke, and level of impairment ranged from severe to less severe. Included studies differed in terms of type, location and duration of stimulation, amount of current delivered, electrode size and positioning, as well as type and location of stroke. We found 23 studies with 781 participants examining the effects of tDCS versus sham tDCS (or any other passive intervention) on our primary outcome measure, ADL after stroke. Nineteen studies with 686 participants reported absolute values and showed evidence of effect regarding ADL performance at the end of the intervention period (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.13 to 0.44; random-effects model; moderate-quality evidence). Four studies with 95 participants reported change scores, and showed an effect (SMD 0.48, 95% CI 0.02 to 0.95; moderate-quality evidence). Six studies with 269 participants assessed the effects of tDCS on ADL at the end of follow-up and provided absolute values, and found improved ADL (SMD 0.31, 95% CI 0.01 to 0.62; moderate-quality evidence). One study with 16 participants provided change scores and found no effect (SMD -0.64, 95% CI -1.66 to 0.37; low-quality evidence). However, the results did not persist in a sensitivity analysis that included only trials with proper allocation concealment. Thirty-four trials with a total of 985 participants measured upper extremity function at the end of the intervention period. Twenty-four studies with 792 participants that presented absolute values found no effect in favour of tDCS (SMD 0.17, 95% CI -0.05 to 0.38; moderate-quality evidence). Ten studies with 193 participants that presented change values also found no effect (SMD 0.33, 95% CI -0.12 to 0.79; low-quality evidence). Regarding the effects of tDCS on upper extremity function at the end of follow-up, we identified five studies with a total of 211 participants (absolute values) without an effect (SMD -0.00, 95% CI -0.39 to 0.39; moderate-quality evidence). Three studies with 72 participants presenting change scores found an effect (SMD 1.07; 95% CI 0.04 to 2.11; low-quality evidence). Twelve studies with 258 participants reported outcome data for lower extremity function and 18 studies with 553 participants reported outcome data on muscle strength at the end of the intervention period, but there was no effect (high-quality evidence). Three studies with 156 participants reported outcome data on muscle strength at follow-up, but there was no evidence of an effect (moderate-quality evidence). Two studies with 56 participants found no evidence of effect of tDCS on cognitive abilities (low-quality evidence), but one study with 30 participants found evidence of effect of tDCS for improving spatial neglect (very low-quality evidence). In 47 studies with 1330 participants, the proportions of dropouts and adverse events were comparable between groups (risk ratio (RR) 1.25, 95% CI 0.74 to 2.13; random-effects model; moderate-quality evidence). AUTHORS' CONCLUSIONS: There is evidence of very low to moderate quality on the effectiveness of tDCS versus control (sham intervention or any other intervention) for improving ADL outcomes after stroke. However, the results did not persist in a sensitivity analyses including only trials with proper allocation concealment. Evidence of low to high quality suggests that there is no effect of tDCS on arm function and leg function, muscle strength, and cognitive abilities in people after stroke. Evidence of very low quality suggests that there is an effect on hemispatial neglect. There was moderate-quality evidence that adverse events and numbers of people discontinuing the treatment are not increased. Future studies should particularly engage with patients who may benefit the most from tDCS after stroke, but also should investigate the effects in routine application. Therefore, further large-scale randomised controlled trials with a parallel-group design and sample size estimation for tDCS are needed.
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Affiliation(s)
- Bernhard Elsner
- Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany
- Department of Physiotherapy, SRH Hochschule für Gesundheit Gera, 07548 Gera, Germany
| | - Joachim Kugler
- Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany
| | - Marcus Pohl
- Neurological Rehabilitation, Helios Klinik Schloss Pulsnitz, Pulsnitz, Germany
| | - Jan Mehrholz
- Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany
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Xing Y, Wei P, Wang C, Shan Y, Yu Y, Qiao Y, Xie B, Shi X, Zhu Z, Lu J, Zhao G, Jia J, Tang Y. TRanscranial AlterNating current Stimulation FOR patients with Mild Alzheimer's Disease (TRANSFORM-AD study): Protocol for a randomized controlled clinical trial. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2020; 6:e12005. [PMID: 32313830 PMCID: PMC7158579 DOI: 10.1002/trc2.12005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 12/26/2019] [Indexed: 12/20/2022]
Abstract
Introduction Recently, transcranial alternating current stimulation (tACS), which can interact with ongoing neuronal activity, has emerged as a potentially effective and promising treatment for Alzheimer's disease (AD), and the 40 Hz gamma frequency was suggested as a suitable stimulation frequency for AD. Methods The TRANSFORM‐AD study is a double‐blind, randomized‐controlled trial that will include 40 individuals with mild AD. Eligible patients need to have amyloid β (Aβ) loads examined by Pittsburgh compound B (PiB) positron emission tomography (PET) or decreased Aβ level in cerebrospinal fluid. Participants will be randomized into either a 40 Hz tACS group or a sham stimulation group. Both groups will undergo 30 one‐hour sessions across 3 weeks (21 days). The outcome measures will be assessed at baseline, at the end of the intervention, and 3 months after the first session. The primary outcome is global cognitive function, assessed by the 11‐item cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS‐Cog), and the secondary outcomes include changes in other neuropsychological assessments and in PiB‐PET, structural magnetic resonance imaging (MRI), resting electroencephalography (EEG), and simultaneous EEG–functional MRI (EEG‐fMRI) results. Results The trial is currently ongoing, and it is anticipated that recruitment will be completed in June 2021. Discussion This trial will evaluate the efficacy and safety of 40 Hz tACS in patients with AD, and further explore the potential mechanisms by analyzing amyloid deposits using PiB‐PET, brain volume and white matter integrity by structural MRI, and neural activity by EEG and EEG‐fMRI.
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Affiliation(s)
- Yi Xing
- Innovation Center for Neurological Disorders Department of Neurology, Xuanwu Hospital Capital Medical University National Clinical Research Center for Geriatric Diseases Beijing China.,Key Laboratory of Neurodegenerative Diseases Ministry of Education of the People's Republic of China Beijing China
| | - Penghu Wei
- Department of Neurosurgery Xuanwu Hospital Capital Medical University Beijing China
| | - Changming Wang
- Department of Neurosurgery Xuanwu Hospital Capital Medical University Beijing China
| | - Yi Shan
- Department of Radiology Xuanwu Hospital Capital Medical University Beijing China
| | - Yueying Yu
- Innovation Center for Neurological Disorders Department of Neurology, Xuanwu Hospital Capital Medical University National Clinical Research Center for Geriatric Diseases Beijing China.,Key Laboratory of Neurodegenerative Diseases Ministry of Education of the People's Republic of China Beijing China
| | - Yuchen Qiao
- Innovation Center for Neurological Disorders Department of Neurology, Xuanwu Hospital Capital Medical University National Clinical Research Center for Geriatric Diseases Beijing China.,Key Laboratory of Neurodegenerative Diseases Ministry of Education of the People's Republic of China Beijing China
| | - Beijia Xie
- Innovation Center for Neurological Disorders Department of Neurology, Xuanwu Hospital Capital Medical University National Clinical Research Center for Geriatric Diseases Beijing China.,Key Laboratory of Neurodegenerative Diseases Ministry of Education of the People's Republic of China Beijing China
| | - Xinrui Shi
- Innovation Center for Neurological Disorders Department of Neurology, Xuanwu Hospital Capital Medical University National Clinical Research Center for Geriatric Diseases Beijing China.,Key Laboratory of Neurodegenerative Diseases Ministry of Education of the People's Republic of China Beijing China
| | - Zhongfang Zhu
- Innovation Center for Neurological Disorders Department of Neurology, Xuanwu Hospital Capital Medical University National Clinical Research Center for Geriatric Diseases Beijing China
| | - Jie Lu
- Department of Radiology Xuanwu Hospital Capital Medical University Beijing China
| | - Guoguang Zhao
- Department of Neurosurgery Xuanwu Hospital Capital Medical University Beijing China
| | - Jianping Jia
- Innovation Center for Neurological Disorders Department of Neurology, Xuanwu Hospital Capital Medical University National Clinical Research Center for Geriatric Diseases Beijing China.,Key Laboratory of Neurodegenerative Diseases Ministry of Education of the People's Republic of China Beijing China
| | - Yi Tang
- Innovation Center for Neurological Disorders Department of Neurology, Xuanwu Hospital Capital Medical University National Clinical Research Center for Geriatric Diseases Beijing China.,Key Laboratory of Neurodegenerative Diseases Ministry of Education of the People's Republic of China Beijing China
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Hordacre B, Comacchio K, Moseley GL. The unusual case of dental pain with sham repetitive transcranial magnetic stimulation: A benign idiosyncrasy or diagnostic opportunity? Brain Stimul 2019; 13:422-423. [PMID: 31859131 DOI: 10.1016/j.brs.2019.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Brenton Hordacre
- Innovation, IMPlementation And Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, 5000, Australia.
| | - Kristina Comacchio
- Innovation, IMPlementation And Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, 5000, Australia
| | - G Lorimer Moseley
- Innovation, IMPlementation And Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, 5000, Australia
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Hordacre B, Moezzi B, Ridding MC. Towards Targeted Brain Stimulation in Stroke: Connectivity as a Biomarker of Response. J Exp Neurosci 2018; 12:1179069518809060. [PMID: 30450005 PMCID: PMC6236477 DOI: 10.1177/1179069518809060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/02/2018] [Indexed: 01/24/2023] Open
Abstract
Stroke is a leading cause of adult disability. New treatments capable of
assisting recovery hold significant potential to improve quality of
life for many stroke survivors. Transcranial direct current
stimulation is one technique that has received much attention due to
its potential to promote neuroplasticity and enhance recovery.
However, current evidence suggests this is not a one-size-fits-all
treatment with indication that responses are highly variable. Using
electroencephalography, Hordacre et al recently demonstrated that
connectivity between the ipsilesional motor cortex, ipsilesional
parietal cortex, and contralesional frontotemporal cortex was a strong
predictor of the neurophysiological response to anodal transcranial
direct current stimulation applied to the ipsilesional motor cortex in
people with chronic ischemic stroke. Based on this outcome, we discuss
the potential for connectivity to be used as a biomarker to target
transcranial direct current stimulation. This includes identification
of a connectivity threshold which could be used to select stroke
survivors who are likely to respond to this potentially beneficial
neuromodulatory treatment. Furthermore, we discuss treatment
approaches for those identified as unlikely to benefit from
ipsilesional anodal transcranial direct current stimulation based on
connectivity profile. This represents an important progression towards
targeting transcranial direct current stimulation for best treatment
outcome based on individual connectivity characteristics.
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Affiliation(s)
- Brenton Hordacre
- Body in Mind, Division of Health
Sciences, University of South Australia, Adelaide, SA, Australia
- Brenton Hordacre, Body in Mind,
Division of Health Sciences, University of South Australia, City East
Campus, GPO Box 2471, Adelaide, SA 5001, Australia.
| | - Bahar Moezzi
- Cognitive Ageing and Impairment
Neurosciences Laboratory, School of Psychology, Social Work and Social
Policy, University of South Australia, Magill, SA, Australia
| | - Michael C Ridding
- Robinson Research Institute,
Adelaide Medical School, The University of Adelaide, Adelaide, SA,
Australia
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