Author, as appears in the article.: Corominas-Teruel, Xavier; Mozo, Rosa Maria San Segundo; Simo, Montserrat Fibla; Colomina Fosch, Maria Teresa; Valero-Cabre, Antoni
Department: Psicologia
URV's Author/s: Colomina Fosch, Maria Teresa / Corominas Teruel, Xavier / Fibla Simó, Montserrat / San Segundo Mozo, Rosa María
Keywords: Transcranial direct cortical stimulation (tdcs) Stroke Non-invasive brain stimulation (nibs) Neurorehabilitation Neuromodulation Motor recovery Gait rehabilitation Biophysical modeling transcranial direct cortical stimulation (tdcs) stroke rehabilitation pilot output neurorehabilitation neuromodulation ischemic-stroke inhibition gait rehabilitation double-blind cortical excitability cognitive impairment clinical-trials biophysical modeling
Abstract: Background: Over the last decade, transcranial direct current stimulation (tDCS) has set promise contributing to post-stroke gait rehabilitation. Even so, results are still inconsistent due to low sample size, heterogeneity of samples, and tDCS design differences preventing comparability. Nonetheless, updated knowledge in post-stroke neurophysiology and stimulation technologies opens up opportunities to massively improve treatments. Objective: The current systematic review aims to summarize the current state-of-the-art on the effects of tDCS applied to stroke subjects for gait rehabilitation, discuss tDCS strategies factoring individual subject profiles, and highlight new promising strategies. Methods: MEDLINE, SCOPUS, CENTRAL, and CINAHL were searched for stroke randomized clinical trials using tDCS for the recovery of gait before 7 February 2022. In order to provide statistical support to the current review, we analyzed the achieved effect sizes and performed statistical comparisons. Results: A total of 24 records were finally included in our review, totaling n = 651 subjects. Detailed analyses revealed n = 4 (17%) studies with large effect sizes (≥0.8), n = 6 (25%) studies with medium ones (≥0.5), and n = 6 (25%) studies yielding low effects sizes (≤ 0.2). Statistically significant negative correlations (rho = −0.65, p = 0.04) and differences (p = 0.03) argued in favor of tDCS interventions in the sub-acute phase. Finally, significant differences (p = 0.03) were argued in favor of a bifocal stimulation montage (anodal M1 ipsilesional and cathodal M1 contralesional) with respect to anodal ipsilesional M1. Conclusion: Our systematic review highlights the potential of tDCS to contribute to gait recovery following stroke, although also the urgent need to improve current stimulation strategies and subject-customized interventions considering stroke severity, type or time-course, and the use of network-based multifocal stimulation approaches guided by computational biophysical modeling. Systematic review registration: PROSPERO: CRD42021256347.
Thematic Areas: Psicología Odontología Neurosciences Neurology (clinical) Neurology Medicina iii Medicina ii Medicina i Interdisciplinar Enfermagem Clinical neurology Ciências biológicas ii Ciências biológicas i Astronomia / física
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: montserrat.fibla@urv.cat rosamaria.sansegundo@urv.cat xavier.corominas@estudiants.urv.cat mariateresa.colomina@urv.cat
Author identifier: 0000-0001-6278-9324 0000-0001-7420-2914 0000-0003-2469-2753 0000-0002-5619-4874
Record's date: 2024-09-28
Papper version: info:eu-repo/semantics/publishedVersion
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: Frontiers In Neurology. 13 953939-
APA: Corominas-Teruel, Xavier; Mozo, Rosa Maria San Segundo; Simo, Montserrat Fibla; Colomina Fosch, Maria Teresa; Valero-Cabre, Antoni (2022). Transcranial direct current stimulation for gait recovery following stroke: A systematic review of current literature and beyond. Frontiers In Neurology, 13(), 953939-. DOI: 10.3389/fneur.2022.953939
Entity: Universitat Rovira i Virgili
Journal publication year: 2022
Publication Type: Journal Publications
Repositori URV