Bihemispheric transcranial direct current stimulation for upper-limb hemiparesis in acute stroke

Takeaway

  • Transcranial direct current stimulation (tDCS) can accelerate the rate of upper limb motor recovery in the acute post-stroke period and could be the only early therapeutic intervention for not delaying rehabilitation to the chronic phase.

Why this matters

  • Spontaneous motor recovery after acute stroke, supported by neuroplastic mechanisms, is limited by the extent of the damage to descending white matter pathways and reaches a plateau within the first 3 months after the event.

  • By modulating cortical excitability, tDCS can increase and speed up the functional reorganization of the motor network and assist with the recovery process.

  • Current evidence indicates that in the acute phase of stroke motor performance relies on remaining corticospinal connections of the affected hemisphere and subsequent recovery relies more on the involvement of alternative cortical networks in both hemispheres.