Transcranial Direct Current Stimulation (tDCS)-Enhanced Stroke Recovery

TDCS-enhanced Stroke Recovery and Cortical Reorganization

The purpose is to determine whether application of a non-invasive battery powered device called transcranial direct current stimulation (tDCS) can improve recovery of hand weakness after stroke beyond what is achievable with rehabilitative treatment alone.

Inclusion Criteria:

• ischemic stroke causing arm weakness within 5-15 days
• no other neurological or psychiatric disease, who are able to perform study tasks

Exclusion Criteria:

• patients younger than 18 or older than 80 years
• patients with more than one disabling stroke
• Patients with bilateral motor impairment
• Patients with poor motivational capacity, history of severe alcohol or drug abuse
• Patients with severe language disturbances, particularly of receptive nature
• Patients with serious cognitive deficits (defined as equivalent to a MMS score of 23 or less)
• Patients with severe uncontrolled medical problems (e.g., seizures, progressive stroke syndromes, severe rheumatoid arthritis, active joint deformity of arthritic origin, active cancer or renal disease, end-stage pulmonary or cardiovascular disease, or a deteriorated condition due to age or others),
• Patients with unstable thyroid disease
• Patients with increased intracranial pressure
• Patients with unstable cardiac arrhythmia
• Patients with contraindication to TMS or tDCS stimulation (pacemaker, an implanted medication pump, a metal plate in the skull, or metal objects inside the eye or skull, patients who had a craniotomy, skin lesions at the site of stimulation)
• Patients who are not available for follow-up at 3 and 12 months
• Pregnancy
• Patients with contraindication to MRI will not participate in MRI