Anodal and Cathodal Transcranial Direct Current Stimulation in Stroke Recovery

Effect of Anodal Versus Cathodal Transcranial Direct Current Stimulation on Stroke Recovery: a Pilot Randomized Controlled Trial

The purpose of this study will to compare the long-term effect of anodal versus cathodal transcranial direct current stimulation (tDCS) on motor recovery in subacute stroke patients. Forty patients with subacute ischemic stroke will randomly assigned to one of three groups: Anodal, Cathodal and Sham. Each group will receive tDCS at an intensity of 2mA for 25 minutes daily for 6 consecutive days over the affected (Anodal, Sham) or unaffected (Cathodal) motor cortex. Patients will be assessed with National Institutes of Health Stroke Scale (NIHSS), the Barthel index (BI) and the Medical Research Council (MRC) muscle strength scale at baseline, after end of the 6th tDCS session, and then 1, 2 and 3 months later. Motor cortical excitability will be measured at baseline and after the 6th session in both hemispheres.

Inclusion Criteria:

• acute hemiparesis with single thromboembolic non-hemorrhagic infarction documented by magnetic resonance imaging (MRI)
• Accept to participate in the study

Exclusion Criteria:

• extensive infarction (taking all territories of middle cerebral artery)
• severe flaccid hemiplegia
• head injury
• Any other neurological disease other than stroke
• previous administration of tranquilizer
• patients who are unable to give informed consent because of severe aphasia, or cognitive deficit.
• Patients with no motor evoked response recorded from First Dorsal Interosseus (FDI) muscle of the affected hand