Creative Commons License 2018 Volume 5 Issue 3

Impact of Anodic Transcranial Direct Current Stimulation (TCDS) on Changes in Movement and Life–Related Functions in Patients with Chronic Ischemic Stroke: A Clinical Tria

Seyed Ahmad Hosseinzadeh, Shahrzad Mazhari, Kiomars Najafi, Meysam Ahmadi, Iraj Aghaei, Masuumeh Niazi, Mohammad Shabani

Stroke is one of the main causes of death; stroke survivors may suffer several neurological impairments. They typically show pathological enhanced neural activity in a number of areas in both hemispheres. Transcranial direct current stimulation (tDCS) can be applied to modify cerebral excitability, which has recently been applied for treatment of neurological disorders.

In this study, 100 patients with chronic ischemic stroke were divided into four groups of control, sham, anodic and cathodic tDCS (n=25). They took routine treatment, and received the same tDCS protocol (three times a week for 30 min per session during one month). Movement and cognitive functions were examined by the National Institute of Health Scale (NIHSS), Barthel index, and Rey test, before and 1 and 3 months after running tDCS sessions. The evaluation of changes in movements and cognitive functions in the chronic ischemic stroke patients was performed using anodic and cathodic tDCS. The results showed that 0-1 month after tDCS, 1-3 months after tDCS, and 0-3 months after tDCS, the NIHSS score and Barthel index significantly increased in the anodic with control, sham and cathodic groups, respectively (P<0.001). Moreover, the Rey test score in 0-1 month after tDCS and 0-3 months after tDCS significantly decreased in the cathodic with control, sham and anodic groups. In sum, anodic and cathodic tDCS have advantageous effects on movement and cognitive rehabilitation in stroke patients; however, this helpful effect was not equal in one domain. Future studies are needed to acknowledge this difference and represent precise treatment protocols. 


Khorasani MZ, Hosseinzadeh SA, Vakili A. Effect of central microinjection of carbenoxolone in an experimental model of focal cerebral ischemia. Pak J Pharm Sci. 2009;22(4):349-54.

Vakili A, Hosseinzadeh SA, Khorasani MZ. Peripheral administration of carbenoxolone reduces ischemic reperfusion injury in transient model of cerebral ischemia. Journal of Stroke and Cerebrovascular Diseases. 2009;18(2):81-5.

Aghaei I, Bakhshayesh B, Ramezani H, Moosazadeh M, Shabani M. The relationship between the serum levels of ferritin and the radiological brain injury indices in patients with spontaneous intracerebral hemorrhage. Iranian journal of basic medical sciences. 2014;17(10):729.

Sunwoo H, Kim Y-H, Chang WH, Noh S, Kim E-J, Ko M-H. Effects of dual transcranial direct current stimulation on post-stroke unilateral visuospatial neglect. Neuroscience letters. 2013;554:94-8.

Grefkes C, Fink GR. Reorganization of cerebral networks after stroke: new insights from neuroimaging with connectivity approaches. Brain. 2011;134(5):1264-76.

Jaberzadeh S, Bastani A, Zoghi M. Anodal transcranial pulsed current stimulation: a novel technique to enhance corticospinal excitability. Clinical Neurophysiology. 2014;125(2):344-51.

Guleyupoglu B, Schestatsky P, Edwards D, Fregni F, Bikson M. Classification of methods in transcranial electrical stimulation (tES) and evolving strategy from historical approaches to contemporary innovations. Journal of neuroscience methods. 2013;219(2):297-311.

Lefaucheur J-P. Methods of therapeutic cortical stimulation. Neurophysiologie Clinique/Clinical Neurophysiology. 2009;39(1):1-14.

Peterchev AV, Wagner TA, Miranda PC, Nitsche MA, Paulus W, Lisanby SH, et al. Fundamentals of transcranial electric and magnetic stimulation dose: definition, selection, and reporting practices. Brain Stimulation. 2012;5(4):435-53.

Bikson M, Datta A, Rahman A, Scaturro J. Electrode montages for tDCS and weak transcranial electrical stimulation: role of “return” electrode’s position and size. Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology. 2010;121(12):1976.

Bikson M, Rahman A, Datta A. Computational models of transcranial direct current stimulation. Clinical EEG and Neuroscience. 2012;43(3):176-83.

Plow EB, Cunningham DA, Beall E, Jones S, Wyant A, Bonnett C, et al. Effectiveness and neural mechanisms associated with tDCS delivered to premotor cortex in stroke rehabilitation: study protocol for a randomized controlled trial. Trials. 2013;14(1):331.

Bastani A, Jaberzadeh S. Does anodal transcranial direct current stimulation enhance excitability of the motor cortex and motor function in healthy individuals and subjects with stroke: a systematic review and meta-analysis. Clinical Neurophysiology. 2012;123(4):644-57.

Notturno F, Pace M, Zappasodi F, Cam E, Bassetti CL, Uncini A. Neuroprotective effect of cathodal transcranial direct current stimulation in a rat stroke model. Journal of the neurological sciences. 2014;342(1-2):146-51.

You DS, Kim D-Y, Chun MH, Jung SE, Park SJ. Cathodal transcranial direct current stimulation of the right Wernicke’s area improves comprehension in subacute stroke patients. Brain and language. 2011;119(1):1-5.

Butler AJ, Shuster M, O'hara E, Hurley K, Middlebrooks D, Guilkey K. A meta-analysis of the efficacy of anodal transcranial direct current stimulation for upper limb motor recovery in stroke survivors. Journal of Hand Therapy. 2013;26(2):162-71.

Lefebvre S, Thonnard J-L, Laloux P, Peeters A, Jamart J, Vandermeeren Y. Single session of dual-tDCS transiently improves precision grip and dexterity of the paretic hand after stroke. Neurorehabilitation and Neural Repair. 2014;28(2):100-10.

Lefebvre S, Dricot L, Laloux P, Gradkowski W, Desfontaines P, Evrard F, et al. Neural substrates underlying stimulation-enhanced motor skill learning after stroke. Brain. 2014;138(1):149-63.

Tanaka S, Takeda K, Otaka Y, Kita K, Osu R, Honda M, et al. Single session of transcranial direct current stimulation transiently increases knee extensor force in patients with hemiparetic stroke. Neurorehabilitation and neural repair. 2011;25(6):565-9.

Lindenberg R, Renga V, Zhu L, Nair D, Schlaug G. Bihemispheric brain stimulation facilitates motor recovery in chronic stroke patients. Neurology. 2010;75(24):2176-84.

Celnik P, Paik N-J, Vandermeeren Y, Dimyan M, Cohen LG. Effects of combined peripheral nerve stimulation and brain polarization on performance of a motor sequence task after chronic stroke. Stroke. 2009;40(5):1764-71.

Boggio PS, Nunes A, Rigonatti SP, Nitsche MA, Pascual-Leone A, Fregni F. Repeated sessions of noninvasive brain DC stimulation is associated with motor function improvement in stroke patients. Restorative neurology and neuroscience. 2007;25(2):123-9.

Au-Yeung SS, Wang J, Chen Y, Chua E. Transcranial direct current stimulation to primary motor area improves hand dexterity and selective attention in chronic stroke. American journal of physical medicine & rehabilitation. 2014;93(12):1057-64.

Utz KS, Dimova V, Oppenländer K, Kerkhoff G. Electrified minds: transcranial direct current stimulation (tDCS) and galvanic vestibular stimulation (GVS) as methods of non-invasive brain stimulation in neuropsychology—a review of current data and future implications. Neuropsychologia. 2010;48(10):2789-810.

Fregni F, Boggio PS, Mansur CG, Wagner T, Ferreira MJ, Lima MC, et al. Transcranial direct current stimulation of the unaffected hemisphere in stroke patients. Neuroreport. 2005;16(14):1551-5.

Kwah LK, Diong J. National Institutes of Health Stroke Scale (NIHSS). Journal of physiotherapy. 2014;60(1):61.

Oveisgharan S, Shirani S, Ghorbani A, Soltanzade A, Baghaei A, Hosseini S, et al. Barthel index in a Middle-East country: translation, validity and reliability. Cerebrovascular Diseases. 2006;22(5-6):350-4.

Akinwuntan AE, Feys H, De Weerdt W, Baten G, Arno P, Kiekens C. Prediction of driving after stroke: a prospective study. Neurorehabilitation and neural repair. 2006;20(3):417-23.

Lefebvre S, Laloux P, Peeters A, Desfontaines P, Jamart J, Vandermeeren Y. Dual-tDCS enhances online motor skill learning and long-term retention in chronic stroke patients. Frontiers in human neuroscience. 2013;6:343.

O'Shea J, Boudrias M-H, Stagg CJ, Bachtiar V, Kischka U, Blicher JU, et al. Predicting behavioural response to TDCS in chronic motor stroke. Neuroimage. 2014;85:924-33.

Danzl MM, Chelette KC, Lee K, Lykins D, Sawaki L. Brain stimulation paired with novel locomotor training with robotic gait orthosis in chronic stroke: a feasibility study. NeuroRehabilitation. 2013;33(1):67-76.

Giacobbe V, Krebs H, Volpe B, Pascual-Leone A, Rykman A, Zeiarati G, et al. Transcranial direct current stimulation (tDCS) and robotic practice in chronic stroke: the dimension of timing. NeuroRehabilitation. 2013;33(1):49-56.

Geroin C, Picelli A, Munari D, Waldner A, Tomelleri C, Smania N. Combined transcranial direct current stimulation and robot-assisted gait training in patients with chronic stroke: a preliminary comparison. Clinical rehabilitation. 2011;25(6):537-48.

Viana R, Laurentino G, Souza R, Fonseca J, Silva Filho E, Dias S, et al. Effects of the addition of transcranial direct current stimulation to virtual reality therapy after stroke: a pilot randomized controlled trial. NeuroRehabilitation. 2014;34(3):437-46.

Hummel F, Celnik P, Giraux P, Floel A, Wu W-H, Gerloff C, et al. Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain. 2005;128(3):490-9.

Hummel F, Cohen LG. Improvement of motor function with noninvasive cortical stimulation in a patient with chronic stroke. Neurorehabilitation and neural repair. 2005;19(1):14-9.

Olma MC, Dargie RA, Behrens JR, Kraft A, Irlbacher K, Fahle M, et al. Long-term effects of serial anodal tDCS on motion perception in subjects with occipital stroke measured in the unaffected visual hemifield. Frontiers in human neuroscience. 2013;7.

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