PTOTSLPMeta-AnalysisJournal of neuroengineering and rehabilitation2025

Noninvasive brain stimulation for upper limb motor activity in children and young adults with cerebral palsy and pediatric stroke: a systematic review and meta-analysis.

Juan-José Fernández-Pérez, Alfredo Lerín-Calvo, David Rodríguez-Martínez and 2 others

PMID 41316406

WHAT IT FOUND

Adding brain stimulation to therapy did not improve upper limb movement in children with cerebral palsy or stroke.

The combined treatment showed no benefit over standard care alone, so clinicians should not expect these stimulation techniques to enhance motor recovery on their own.

Key findings

01Neither repetitive transcranial magnetic stimulation (rTMS) nor transcranial direct current stimulation (tDCS) produced a statistically significant improvement in upper limb motor activity compared to sham or control conditions.

02The review found moderate certainty evidence that non-invasive brain stimulation does not demonstrate additional clinical effects on upper limb activity in children, requiring further high-quality research.

03While individual studies showed mixed results, the overall pooled analysis indicated no significant effect for either stimulation technique when applied in isolation or as an adjunct to usual rehabilitation.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The sample size for the meta-analysis was small, and the studies included had varying methodological quality. There was significant heterogeneity in tDCS protocols, including differences in electrode placement, intensity, and session numbers, making comparisons difficult. Subgroup analyses by severity of impairment (MACS levels) were not possible due to insufficient data stratification. The age range extended to 30 years, which may dilute the strict pediatric focus of the review.

Declared interests

The study was funded by Neuron Clinic.

The easy way to misread this

Do not interpret the null overall result as proof that brain stimulation never works for any child. The authors note a trend where recent studies using multiple sessions and combined intensive training showed some positive shifts, but the current pooled evidence remains insufficient to recommend these protocols.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →