Transcranial Direct Current Stimulation in Pediatric Motor Disorders: A Systematic Review and Meta-analysis.
Ghazala T Saleem, Jewel E Crasta, Beth S Slomine and 2 others
PMID 30414398WHAT IT FOUND
Transcranial direct current stimulation appears safe and tolerable for children with motor disorders.
It improved some gait measures and reduced spasticity, but effects on balance, hand function, and daily activities were inconsistent or absent. Most studies were small and often combined tDCS with other therapies.
Key findings
01tDCS showed no difference in dropout rates compared to sham, with only mild adverse effects like tingling and discomfort reported.
02Anodal tDCS significantly improved walking velocity, stride length, and cadence compared to sham, but did not improve step length or width.
03Effects on balance, upper-extremity function, and daily participation were mixed, with significant improvements in some gait and tone measures but null findings for others.
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
Sample sizes in the included RCTs were small, limiting the certainty of the findings. Many studies combined tDCS with other interventions (e.g., treadmill training), so the independent effect of tDCS cannot be determined. The review included only English-language studies, which may introduce publication bias. Subgroup analyses could not be conducted due to the limited number of studies. Trend-level findings were included in the analysis, which may have led to an overestimation of tDCS effects.
Declared interests
The authors declared no conflicts of interest. The study was supported by NIH and non-US government research funding.
The easy way to misread this
Do not assume tDCS works independently. Most positive results came from studies where tDCS was delivered concurrently with physical therapies like treadmill training or constraint-induced movement therapy. The review explicitly states that the contribution of tDCS alone versus the combined intervention cannot be separated, so it should not be viewed as a standalone treatment.