Resting-state hemodynamic changes and effects on upper limb function after multi-channel transcranial direct current stimulation to the ipsilesional primary motor cortex and anterior intraparietal sulcus in stroke patients: an fNIRS pilot study.
Seung Hyun Lee, Gihyoun Lee, Jinuk Kim and 8 others
PMID 40241110WHAT IT FOUND
FMA-UE upper limb scores did not improve more with real tDCS added to exercises than sham added to exercises.
The Box and Block Test favoured real tDCS, but this pilot cannot show tDCS works.
Key findings
01In the real-tDCS and sham groups, both of which received upper limb exercises, the group × time interaction for total FMA-UE and subscales was not significant (adjusted p = 0.114).
02The Box and Block Test, after real tDCS plus exercises versus sham plus exercises, showed a significant group × time interaction (adjusted p = 0.004), but other upper limb functional assessments did not.
03After real tDCS plus exercises versus sham plus exercises, nonlesion-side accumulated oxyhemoglobin increased significantly more with real stimulation (p = 0.033); lesion-side was not significant (p = 0.058).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The analysis included 24 participants, so the study is small and may not detect true differences or generalise to all stroke patients. The real and sham groups differed in stroke type, with 6 infarction and 6 hemorrhage cases versus 11 infarction and 1 hemorrhage case; the authors used stroke type as a covariate. Participants with lesions in M1 or aIPS were excluded, which may not represent many stroke patients with motor impairment from those areas. The FMA-UE outcome was null, while the Box and Block Test result was one of multiple functional outcomes reported. Both groups received upper limb motor exercises with stimulation, so the contribution of tDCS alone cannot be separated from the exercises. fNIRS was measured before and after sessions, not during stimulation, so the study cannot fully characterise the timing of hemodynamic changes. Session frequency varied because of scheduling, and outcomes were assessed only immediately after the 10-session course.
Declared interests
The only funding statement provided is 'Funder: None'.
The easy way to misread this
Do not conclude that multi-channel tDCS improves upper limb function. The FMA-UE total score did not show a significant group difference, and participants in both groups also received upper limb motor exercises, so any Box and Block Test improvement cannot be credited to tDCS alone.