Transcranial direct current stimulation for promoting motor function in cerebral palsy: a review.
Melanie K Fleming, Tim Theologis, Rachel Buckingham and 1 others
PMID 30572926WHAT IT FOUND
tDCS paired with training was linked to better walking speed, balance and mobility in children and adolescents with cerebral palsy, but upper limb motor gains remain unclear.
Key findings
01In a lower limb study combining anodal tDCS with virtual-reality gait training, the active group improved walking velocity and cadence more than sham.
02Upper limb studies did not show clear added benefit of tDCS for active motor function beyond motor training or constraint-induced movement therapy.
03In a study that combined anodal tDCS with routine physical therapy, including stretching, positioning and aerobic exercise, the active group improved spasticity and passive shoulder abduction range of movement.
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 narrative review, not a systematic review or meta-analysis, so the authors selected studies by topic relevance rather than a transparent exhaustive search. The included studies were small, heterogeneous and often short-term, limiting confidence in the size and durability of any effect. Some upper limb studies lacked sham comparisons, and participants often received physical therapy or other training alongside tDCS, making it hard to separate the contribution of each component. Neurophysiological studies were few and did not clearly show that changes were specific to the targeted brain region or time course. Predictors of response are uncertain, and electrode placement may require individualised assessment of corticospinal tract integrity.
Declared interests
The funding declaration provided names the Wellcome Trust.
The easy way to misread this
Do not conclude that tDCS is an established treatment for motor function in cerebral palsy. The review includes small, mixed studies, and the authors call for larger longitudinal studies.