Research progress of transcranial direct current stimulation for post-stroke dysfunction_West China Medical Journal

Authors：

ZOU Wenchen ¹ , ZHU Lu ^1,2 , JIA Yiying ¹ ,  ZHANG Zhiqiang ^1,2

1. Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110134, P. R. China;
2. The Second Clinical College of China Medical University, Shenyang, Liaoning 110122, P. R. China;

Corresponding author：

ZHANG Zhiqiang, Email: zhangzq@sj-hospital.org

Keywords：

Transcranial direct current stimulation; stroke; dysfunction; dyskinesia; cognitive dysfunction

DOI：

10.7507/1002-0179.202203141

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Transcranial direct current stimulation (tDCS) is a non-invasive technique that uses constant low-intensity direct current (1 to 2 mA) to regulate neuronal activity in the cerebral cortex. In recent years, tDCS has received more and more attention as a tool to explore human brain function and treat various neurological diseases. However, there is still a lack of systematic and comprehensive reviews in the tDCS treatment of post-stroke dysfunction. This article reviews the treatment of post-stroke dysfunction with tDCS, integrates relevant basic research and clinical research in recent years, summarizes and discusses the theoretical mechanism and application effect of tDCS in the treatment of post-stroke dysfunction, so as to provide a basis for further research.

Citation： ZOU Wenchen, ZHU Lu, JIA Yiying, ZHANG Zhiqiang. Research progress of transcranial direct current stimulation for post-stroke dysfunction. West China Medical Journal, 2022, 37(5): 668-673. doi: 10.7507/1002-0179.202203141 Copy

1.	Gittler M, Davis AM. Guidelines for adult stroke rehabilitation and recovery. JAMA, 2018, 319(8): 820-821.
2.	Zhang T, Zhao J, Li X, et al. Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of stroke rehabilitation. Stroke Vasc Neurol, 2020, 5(3): 250-259.
3.	Bikson M, Hanlon CA, Woods AJ, et al. Guidelines for TMS/tES clinical services and research through the COVID-19 pandemic. Brain Stimul, 2020, 13(4): 1124-1149.
4.	Elsner B, Kugler J, Pohl M, et al. Transcranial direct current stimulation (tDCS) for improving function and activities of daily living in patients after stroke. Cochrane Database Syst Rev, 2013(11): CD009645.
5.	Denissen S, Staring W, Kunkel D, et al. Interventions for preventing falls in people after stroke. Stroke, 2020, 51(3): e47-e48.
6.	Bucur M, Papagno C. Are transcranial brain stimulation effects long-lasting in post-stroke aphasia? A comparative systematic review and meta-analysis on naming performance. Neurosci Biobehav Rev, 2019, 102: 264-289.
7.	Lefaucheur JP, Antal A, Ayache SS, et al. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clin Neurophysiol, 2017, 128(1): 56-92.
8.	Vöröslakos M, Takeuchi Y, Brinyiczki K, et al. Direct effects of transcranial electric stimulation on brain circuits in rats and humans. Nat Commun, 2018, 9(1): 483.
9.	Chase HW, Boudewyn MA, Carter CS, et al. Transcranial direct current stimulation: a roadmap for research, from mechanism of action to clinical implementation. Mol Psychiatry, 2020, 25(2): 397-407.
10.	Orrù G, Conversano C, Hitchcott PK, et al. Motor stroke recovery after tDCS: a systematic review. Rev Neurosci, 2020, 31(2): 201-218.
11.	Schjetnan AG, Gidyk DC, Metz GA, et al. Anodal transcranial direct current stimulation with monopolar pulses improves limb use after stroke by enhancing inter-hemispheric coherence. Acta Neurobiol Exp (Wars), 2019, 79(3): 290-301.
12.	Ahn SM, Jung DH, Lee HJ, et al. Contralesional application of transcranial direct current stimulation on functional improvement in ischemic stroke mice. Stroke, 2020, 51(7): 2208-2218.
13.	Duan JX, Zheng MG, Mu SH, et al. Transcranial direct current stimulation treated by multilead brain reflex instrument accelerates neural functional recovery in a rat model of stroke. Int J Neurosci, 2021, 131(6): 571-579.
14.	Hayward KS, Kramer SF, Dalton EJ, et al. Timing and dose of upper limb motor intervention after stroke: a systematic review. Stroke, 2021, 52(11): 3706-3717.
15.	Bornheim S, Croisier JL, Maquet P, et al. Transcranial direct current stimulation associated with physical-therapy in acute stroke patients-a randomized, triple blind, sham-controlled study. Brain Stimul, 2020, 13(2): 329-336.
16.	Bolognini N, Russo C, Souza Carneiro MI, et al. Bi-hemispheric transcranial direct current stimulation for upper-limb hemiparesis in acute stroke: a randomized, double-blind, sham-controlled trial. Eur J Neurol, 2020, 27(12): 2473-2482.
17.	Kuo IJ, Tang CW, Tsai YA, et al. Neurophysiological signatures of hand motor response to dual-transcranial direct current stimulation in subacute stroke: a TMS and MEG study. J Neuroeng Rehabil, 2020, 17(1): 72.
18.	Chen SC, Yang LY, Adeel M, et al. Transcranial electrostimulation with special waveforms enhances upper-limb motor function in patients with chronic stroke: a pilot randomized controlled trial. J Neuroeng Rehabil, 2021, 18(1): 106.
19.	Liao WW, Chiang WC, Lin KC, et al. Timing-dependent effects of transcranial direct current stimulation with mirror therapy on daily function and motor control in chronic stroke: a randomized controlled pilot study. J Neuroeng Rehabil, 2020, 17(1): 101.
20.	Yao X, Cui L, Wang J, et al. Effects of transcranial direct current stimulation with virtual reality on upper limb function in patients with ischemic stroke: a randomized controlled trial. J Neuroeng Rehabil, 2020, 17(1): 73.
21.	Salazar AP, Cimolin V, Schifino GP, et al. Bi-cephalic transcranial direct current stimulation combined with functional electrical stimulation for upper-limb stroke rehabilitation: a double-blind randomized controlled trial. Ann Phys Rehabil Med, 2020, 63(1): 4-11.
22.	Rudberg AS, Berge E, Laska AC, et al. Stroke survivors’ priorities for research related to life after stroke. Top Stroke Rehabil, 2021, 28(2): 153-158.
23.	Vaz PG, Salazar APDS, Stein C, et al. Noninvasive brain stimulation combined with other therapies improves gait speed after stroke: a systematic review and meta-analysis. Top Stroke Rehabil, 2019, 26(3): 201-213.
24.	Madhavan S, Cleland BT, Sivaramakrishnan A, et al. Cortical priming strategies for gait training after stroke: a controlled, stratified trial. J Neuroeng Rehabil, 2020, 17(1): 111.
25.	Cattagni T, Geiger M, Supiot A, et al. A single session of anodal transcranial direct current stimulation applied over the affected primary motor cortex does not alter gait parameters in chronic stroke survivors. Neurophysiol Clin, 2019, 49(4): 283-293.
26.	Coppens MJM, Staring WHA, Nonnekes J, et al. Offline effects of transcranial direct current stimulation on reaction times of lower extremity movements in people after stroke: a pilot cross-over study. J Neuroeng Rehabil, 2019, 16(1): 136.
27.	Elsner B, Kugler J, Pohl M, et al. Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke. Cochrane Database Syst Rev, 2019, 5(5): CD009760.
28.	Avena-Koenigsberger A, Misic B, Sporns O. Communication dynamics in complex brain networks. Nat Rev Neurosci, 2017, 19(1): 17-33.
29.	Wilmskoetter J, Fridriksson J, Basilakos A, et al. Indirect white matter pathways are associated with treated naming improvement in aphasia. Neurorehabil Neural Repair, 2021, 35(4): 346-355.
30.	Darkow R, Martin A, Würtz A, et al. Transcranial direct current stimulation effects on neural processing in post-stroke aphasia. Hum Brain Mapp, 2017, 38(3): 1518-1531.
31.	Branscheidt M, Hoppe J, Zwitserlood P, et al. tDCS over the motor cortex improves lexical retrieval of action words in poststroke aphasia. J Neurophysiol, 2018, 119(2): 621-630.
32.	Fridriksson J, Rorden C, Elm J, et al. Transcranial direct current stimulation vs sham stimulation to treat aphasia after stroke: a randomized clinical trial. JAMA Neurol, 2018, 75(12): 1470-1476.
33.	Zhao Q, Wang J, Li Z, et al. Effect of anodic transcranial direct current stimulation combined with speech language therapy on nonfluent poststroke aphasia. Neuromodulation, 2021, 24(5): 923-929.
34.	Fridriksson J, Elm J, Stark BC, et al. BDNF genotype and tDCS interaction in aphasia treatment. Brain Stimul, 2018, 11(6): 1276-1281.
35.	Spielmann K, van de Sandt-Koenderman WME, Heijenbrok-Kal MH, et al. Transcranial direct current stimulation does not improve language outcome in subacute poststroke aphasia. Stroke, 2018, 49(4): 1018-1020.
36.	Woodhead ZVJ, Kerry SJ, Aguilar OM, et al. Randomized trial of iReadMore word reading training and brain stimulation in central alexia. Brain, 2018, 141(7): 2127-2141.
37.	Pestalozzi MI, Di Pietro M, Martins Gaytanidis C, et al. Effects of prefrontal transcranial direct current stimulation on lexical access in chronic poststroke aphasia. Neurorehabil Neural Repair, 2018, 32(10): 913-923.
38.	Smith EE, Kent DM, Bulsara KR, et al. Effect of dysphagia screening strategies on clinical outcomes after stroke: a systematic review for the 2018 guidelines for the early management of patients with acute ischemic stroke. Stroke, 2018, 49(3): e123-e128.
39.	Kumar S, Schlaug G. Enhancing swallowing recovery after a stroke by harnessing its bihemispheric organization. Ann Neurol, 2018, 83(4): 658-660.
40.	Suntrup-Krueger S, Ringmaier C, Muhle P, et al. Randomized trial of transcranial direct current stimulation for poststroke dysphagia. Ann Neurol, 2018, 83(2): 328-340.
41.	Mao H, Lyu Y, Li Y, et al. Clinical study on swallowing function of brainstem stroke by tDCS. Neurol Sci, 2022, 43(1): 477-484.
42.	Marchina S, Pisegna JM, Massaro JM, et al. Transcranial direct current stimulation for post-stroke dysphagia: a systematic review and meta-analysis of randomized controlled trials. J Neurol, 2021, 268(1): 293-304.
43.	Pingue V, Priori A, Malovini A, et al. Dual transcranial direct current stimulation for poststroke dysphagia: a randomized controlled trial. Neurorehabil Neural Repair, 2018, 32(6/7): 635-644.
44.	Yan RB, Zhang XL, Li YH, et al. Effect of transcranial direct-current stimulation on cognitive function in stroke patients: a systematic review and meta-analysis. PLoS One, 2020, 15(6): e0233903.
45.	van Lieshout ECC, van Hooijdonk RF, Dijkhuizen RM, et al. The effect of noninvasive brain stimulation on poststroke cognitive function: a systematic review. Neurorehabil Neural Repair, 2019, 33(5): 355-374.
46.	Kolskår KK, Richard G, Alnaes D, et al. Reliability, sensitivity, and predictive value of fMRI during multiple object tracking as a marker of cognitive training gain in combination with tDCS in stroke survivors. Hum Brain Mapp, 2021, 42(4): 1167-1181.
47.	Turgut N, Miranda M, Kastrup A, et al. tDCS combined with optokinetic drift reduces egocentric neglect in severely impaired post-acute patients. Neuropsychol Rehabil, 2018, 28(4): 515-526.
48.	Làdavas E, Giulietti S, Avenanti A, et al. A-tDCS on the ipsilesional parietal cortex boosts the effects of prism adaptation treatment in neglect. Restor Neurol Neurosci, 2015, 33(5): 647-662.
49.	Ayerbe L, Ayis S, Wolfe CD, et al. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry, 2013, 202(1): 14-21.
50.	Bucur M, Papagno C. A systematic review of noninvasive brain stimulation for post-stroke depression. J Affect Disord, 2018, 238: 69-78.
51.	Li H, Zhu N, Klomparens EA, et al. Application of functional near-infrared spectroscopy to explore the neural mechanism of transcranial direct current stimulation for post-stroke depression. Neurol Res, 2019, 41(8): 714-721.
52.	An TG, Kim SH, Kim KU. Effect of transcranial direct current stimulation of stroke patients on depression and quality of life. J Phys Ther Sci, 2017, 29(3): 505-507.
53.	Basser PJ, Roth BJ. New currents in electrical stimulation of excitable tissues. Annu Rev Biomed Eng, 2000, 2: 377-397.

1. Gittler M, Davis AM. Guidelines for adult stroke rehabilitation and recovery. JAMA, 2018, 319(8): 820-821.
2. Zhang T, Zhao J, Li X, et al. Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of stroke rehabilitation. Stroke Vasc Neurol, 2020, 5(3): 250-259.
3. Bikson M, Hanlon CA, Woods AJ, et al. Guidelines for TMS/tES clinical services and research through the COVID-19 pandemic. Brain Stimul, 2020, 13(4): 1124-1149.
4. Elsner B, Kugler J, Pohl M, et al. Transcranial direct current stimulation (tDCS) for improving function and activities of daily living in patients after stroke. Cochrane Database Syst Rev, 2013(11): CD009645.
5. Denissen S, Staring W, Kunkel D, et al. Interventions for preventing falls in people after stroke. Stroke, 2020, 51(3): e47-e48.
6. Bucur M, Papagno C. Are transcranial brain stimulation effects long-lasting in post-stroke aphasia? A comparative systematic review and meta-analysis on naming performance. Neurosci Biobehav Rev, 2019, 102: 264-289.
7. Lefaucheur JP, Antal A, Ayache SS, et al. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clin Neurophysiol, 2017, 128(1): 56-92.
8. Vöröslakos M, Takeuchi Y, Brinyiczki K, et al. Direct effects of transcranial electric stimulation on brain circuits in rats and humans. Nat Commun, 2018, 9(1): 483.
9. Chase HW, Boudewyn MA, Carter CS, et al. Transcranial direct current stimulation: a roadmap for research, from mechanism of action to clinical implementation. Mol Psychiatry, 2020, 25(2): 397-407.
10. Orrù G, Conversano C, Hitchcott PK, et al. Motor stroke recovery after tDCS: a systematic review. Rev Neurosci, 2020, 31(2): 201-218.
11. Schjetnan AG, Gidyk DC, Metz GA, et al. Anodal transcranial direct current stimulation with monopolar pulses improves limb use after stroke by enhancing inter-hemispheric coherence. Acta Neurobiol Exp (Wars), 2019, 79(3): 290-301.
12. Ahn SM, Jung DH, Lee HJ, et al. Contralesional application of transcranial direct current stimulation on functional improvement in ischemic stroke mice. Stroke, 2020, 51(7): 2208-2218.
13. Duan JX, Zheng MG, Mu SH, et al. Transcranial direct current stimulation treated by multilead brain reflex instrument accelerates neural functional recovery in a rat model of stroke. Int J Neurosci, 2021, 131(6): 571-579.
14. Hayward KS, Kramer SF, Dalton EJ, et al. Timing and dose of upper limb motor intervention after stroke: a systematic review. Stroke, 2021, 52(11): 3706-3717.
15. Bornheim S, Croisier JL, Maquet P, et al. Transcranial direct current stimulation associated with physical-therapy in acute stroke patients-a randomized, triple blind, sham-controlled study. Brain Stimul, 2020, 13(2): 329-336.
16. Bolognini N, Russo C, Souza Carneiro MI, et al. Bi-hemispheric transcranial direct current stimulation for upper-limb hemiparesis in acute stroke: a randomized, double-blind, sham-controlled trial. Eur J Neurol, 2020, 27(12): 2473-2482.
17. Kuo IJ, Tang CW, Tsai YA, et al. Neurophysiological signatures of hand motor response to dual-transcranial direct current stimulation in subacute stroke: a TMS and MEG study. J Neuroeng Rehabil, 2020, 17(1): 72.
18. Chen SC, Yang LY, Adeel M, et al. Transcranial electrostimulation with special waveforms enhances upper-limb motor function in patients with chronic stroke: a pilot randomized controlled trial. J Neuroeng Rehabil, 2021, 18(1): 106.
19. Liao WW, Chiang WC, Lin KC, et al. Timing-dependent effects of transcranial direct current stimulation with mirror therapy on daily function and motor control in chronic stroke: a randomized controlled pilot study. J Neuroeng Rehabil, 2020, 17(1): 101.
20. Yao X, Cui L, Wang J, et al. Effects of transcranial direct current stimulation with virtual reality on upper limb function in patients with ischemic stroke: a randomized controlled trial. J Neuroeng Rehabil, 2020, 17(1): 73.
21. Salazar AP, Cimolin V, Schifino GP, et al. Bi-cephalic transcranial direct current stimulation combined with functional electrical stimulation for upper-limb stroke rehabilitation: a double-blind randomized controlled trial. Ann Phys Rehabil Med, 2020, 63(1): 4-11.
22. Rudberg AS, Berge E, Laska AC, et al. Stroke survivors’ priorities for research related to life after stroke. Top Stroke Rehabil, 2021, 28(2): 153-158.
23. Vaz PG, Salazar APDS, Stein C, et al. Noninvasive brain stimulation combined with other therapies improves gait speed after stroke: a systematic review and meta-analysis. Top Stroke Rehabil, 2019, 26(3): 201-213.
24. Madhavan S, Cleland BT, Sivaramakrishnan A, et al. Cortical priming strategies for gait training after stroke: a controlled, stratified trial. J Neuroeng Rehabil, 2020, 17(1): 111.
25. Cattagni T, Geiger M, Supiot A, et al. A single session of anodal transcranial direct current stimulation applied over the affected primary motor cortex does not alter gait parameters in chronic stroke survivors. Neurophysiol Clin, 2019, 49(4): 283-293.
26. Coppens MJM, Staring WHA, Nonnekes J, et al. Offline effects of transcranial direct current stimulation on reaction times of lower extremity movements in people after stroke: a pilot cross-over study. J Neuroeng Rehabil, 2019, 16(1): 136.
27. Elsner B, Kugler J, Pohl M, et al. Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke. Cochrane Database Syst Rev, 2019, 5(5): CD009760.
28. Avena-Koenigsberger A, Misic B, Sporns O. Communication dynamics in complex brain networks. Nat Rev Neurosci, 2017, 19(1): 17-33.
29. Wilmskoetter J, Fridriksson J, Basilakos A, et al. Indirect white matter pathways are associated with treated naming improvement in aphasia. Neurorehabil Neural Repair, 2021, 35(4): 346-355.
30. Darkow R, Martin A, Würtz A, et al. Transcranial direct current stimulation effects on neural processing in post-stroke aphasia. Hum Brain Mapp, 2017, 38(3): 1518-1531.
31. Branscheidt M, Hoppe J, Zwitserlood P, et al. tDCS over the motor cortex improves lexical retrieval of action words in poststroke aphasia. J Neurophysiol, 2018, 119(2): 621-630.
32. Fridriksson J, Rorden C, Elm J, et al. Transcranial direct current stimulation vs sham stimulation to treat aphasia after stroke: a randomized clinical trial. JAMA Neurol, 2018, 75(12): 1470-1476.
33. Zhao Q, Wang J, Li Z, et al. Effect of anodic transcranial direct current stimulation combined with speech language therapy on nonfluent poststroke aphasia. Neuromodulation, 2021, 24(5): 923-929.
34. Fridriksson J, Elm J, Stark BC, et al. BDNF genotype and tDCS interaction in aphasia treatment. Brain Stimul, 2018, 11(6): 1276-1281.
35. Spielmann K, van de Sandt-Koenderman WME, Heijenbrok-Kal MH, et al. Transcranial direct current stimulation does not improve language outcome in subacute poststroke aphasia. Stroke, 2018, 49(4): 1018-1020.
36. Woodhead ZVJ, Kerry SJ, Aguilar OM, et al. Randomized trial of iReadMore word reading training and brain stimulation in central alexia. Brain, 2018, 141(7): 2127-2141.
37. Pestalozzi MI, Di Pietro M, Martins Gaytanidis C, et al. Effects of prefrontal transcranial direct current stimulation on lexical access in chronic poststroke aphasia. Neurorehabil Neural Repair, 2018, 32(10): 913-923.
38. Smith EE, Kent DM, Bulsara KR, et al. Effect of dysphagia screening strategies on clinical outcomes after stroke: a systematic review for the 2018 guidelines for the early management of patients with acute ischemic stroke. Stroke, 2018, 49(3): e123-e128.
39. Kumar S, Schlaug G. Enhancing swallowing recovery after a stroke by harnessing its bihemispheric organization. Ann Neurol, 2018, 83(4): 658-660.
40. Suntrup-Krueger S, Ringmaier C, Muhle P, et al. Randomized trial of transcranial direct current stimulation for poststroke dysphagia. Ann Neurol, 2018, 83(2): 328-340.
41. Mao H, Lyu Y, Li Y, et al. Clinical study on swallowing function of brainstem stroke by tDCS. Neurol Sci, 2022, 43(1): 477-484.
42. Marchina S, Pisegna JM, Massaro JM, et al. Transcranial direct current stimulation for post-stroke dysphagia: a systematic review and meta-analysis of randomized controlled trials. J Neurol, 2021, 268(1): 293-304.
43. Pingue V, Priori A, Malovini A, et al. Dual transcranial direct current stimulation for poststroke dysphagia: a randomized controlled trial. Neurorehabil Neural Repair, 2018, 32(6/7): 635-644.
44. Yan RB, Zhang XL, Li YH, et al. Effect of transcranial direct-current stimulation on cognitive function in stroke patients: a systematic review and meta-analysis. PLoS One, 2020, 15(6): e0233903.
45. van Lieshout ECC, van Hooijdonk RF, Dijkhuizen RM, et al. The effect of noninvasive brain stimulation on poststroke cognitive function: a systematic review. Neurorehabil Neural Repair, 2019, 33(5): 355-374.
46. Kolskår KK, Richard G, Alnaes D, et al. Reliability, sensitivity, and predictive value of fMRI during multiple object tracking as a marker of cognitive training gain in combination with tDCS in stroke survivors. Hum Brain Mapp, 2021, 42(4): 1167-1181.
47. Turgut N, Miranda M, Kastrup A, et al. tDCS combined with optokinetic drift reduces egocentric neglect in severely impaired post-acute patients. Neuropsychol Rehabil, 2018, 28(4): 515-526.
48. Làdavas E, Giulietti S, Avenanti A, et al. A-tDCS on the ipsilesional parietal cortex boosts the effects of prism adaptation treatment in neglect. Restor Neurol Neurosci, 2015, 33(5): 647-662.
49. Ayerbe L, Ayis S, Wolfe CD, et al. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry, 2013, 202(1): 14-21.
50. Bucur M, Papagno C. A systematic review of noninvasive brain stimulation for post-stroke depression. J Affect Disord, 2018, 238: 69-78.
51. Li H, Zhu N, Klomparens EA, et al. Application of functional near-infrared spectroscopy to explore the neural mechanism of transcranial direct current stimulation for post-stroke depression. Neurol Res, 2019, 41(8): 714-721.
52. An TG, Kim SH, Kim KU. Effect of transcranial direct current stimulation of stroke patients on depression and quality of life. J Phys Ther Sci, 2017, 29(3): 505-507.
53. Basser PJ, Roth BJ. New currents in electrical stimulation of excitable tissues. Annu Rev Biomed Eng, 2000, 2: 377-397.

West China Medical Journal

Research progress of transcranial direct current stimulation for post-stroke dysfunction

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content