Revisiting interhemispheric imbalance in chronic stroke: A tDCS study.

Show simple item record McCambridge, Alana B en Stinear, James en Byblow, Winston en 2018-10-11T22:29:24Z en 2018-01 en
dc.identifier.issn 1388-2457 en
dc.identifier.uri en
dc.description.abstract OBJECTIVE:Chronic stroke patients with moderate-severe motor impairment may have an increased reliance on contralesional vs ipsilesional motor areas to control the paretic arm. We hypothesised that increasing contralesional excitability with anodal transcranial direct current stimulation (a-tDCS) would benefit motor performance in patients with moderate-severe impairment. METHODS:Ten patients with motor impairment at the chronic stage after stroke received a-tDCS, cathodal (c-tDCS) and sham with the target electrode over contralesional motor cortex (M1). Motor performance was quantified from the circularity and size of planar movements made with the paretic arm. Contralateral and ipsilateral corticospinal excitability was inferred using transcranial magnetic stimulation. Corticospinal tract integrity and basal GABA concentration were assessed with magnetic resonance imaging and spectroscopy. RESULTS:Anodal tDCS increased contralesional corticomotor excitability evident from motor evoked potentials in both wrist extensors (both P<0.043). Cathodal tDCS did not affect corticomotor excitability (P>0.37). The effect of tDCS on motor performance with the paretic limb was negatively associated with ipsilesional GABA concentration after c-tDCS (P=0.001). CONCLUSIONS:Further investigation of noninvasive brain stimulation protocols that facilitate contralesional M1 is warranted. SIGNIFICANCE:The inter-hemispheric imbalance model of stroke recovery may not apply to patients with more severe impairment. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri en
dc.subject Arm en
dc.subject Motor Cortex en
dc.subject Pyramidal Tracts en
dc.subject Humans en
dc.subject Motor Skills en
dc.subject Evoked Potentials, Motor en
dc.subject Aged en
dc.subject Middle Aged en
dc.subject Female en
dc.subject Male en
dc.subject Functional Laterality en
dc.subject Stroke en
dc.subject Transcranial Direct Current Stimulation en
dc.subject Stroke Rehabilitation en
dc.title Revisiting interhemispheric imbalance in chronic stroke: A tDCS study. en
dc.type Journal Article en
dc.identifier.doi 10.1016/j.clinph.2017.10.016 en
pubs.issue 1 en
pubs.begin-page 42 en
pubs.volume 129 en
dc.rights.holder Copyright: The author en
dc.identifier.pmid 29145166 en
pubs.end-page 50 en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype Randomized Controlled Trial en
pubs.subtype Journal Article en
pubs.elements-id 718103 en Science en Exercise Sciences en
dc.identifier.eissn 1872-8952 en
pubs.record-created-at-source-date 2017-11-18 en
pubs.dimensions-id 29145166 en

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