Transcranial Direct Current Stimulation for Poststroke Motor Recovery: Challenges and Opportunities.
Wuwei Feng, Steven A Kautz, Gottfried Schlaug and 3 others
PMID 30269802WHAT IT FOUND
tDCS is not ready for routine poststroke motor recovery.
The review says efficacy data are mixed, optimal dose is unclear, and patient selection, safety, and trial design issues remain.
Key findings
01Evidence for tDCS in poststroke motor recovery is mixed and inconsistent, and the review says unresolved issues remain before widespread clinical use.
02A meta-analysis of tDCS stroke motor studies suggested bihemispheric montage may have better success odds than unihemispheric montages for reducing motor impairment on the Fugl-Meyer Motor Scale.
03Patient selection may affect response: milder upper limb deficits and signs that some motor pathway function remains may respond better than severe deficits or large lesions damaging the motor pathway.
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
This is a review, not an original clinical trial, so it does not report a primary outcome or new patient results. The supplied text does not include a methods section, search strategy, or appraisal of the studies it discusses. It notes mixed efficacy and unresolved dose, montage, safety, patient-selection, and trial-design questions. It does not support a specific clinical tDCS protocol. Safety statements about skull defects and conductive implants are qualitative and do not report how often such cases occur in practice.
The easy way to misread this
Do not read this review as proof that tDCS improves poststroke motor recovery. The paper says efficacy data are mixed and several issues must be resolved before widespread clinical use.