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Transcranial direct current stimulation (tDCS) had recently been shown having feasibility in modulating cortical excitability transiently during motor training in a noninvasive way. The findings support that tDCS and motor practice can positively promote post-stroke motor learning to improve upper-limb motor recovery after stroke. A randomized controlled trial will be conducted with three groups: HD-tDCS, conventional tDCS and sham HD-tDCS. A 10-session training will be provided to evaluate the effectiveness of transient modulation of cortical excitability through tDCS with clinical assessment scores.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HD-tDCS group | Experimental | Constant current (1mA) will be applied for 20min and the anode will be placed over the defined target area |
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| Conventional tDCS group | Experimental | Constant current (1mA) will be applied for 20min and the anode will be placed over the standard C3/C4 position |
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| Sham HD-tDCS group | Sham Comparator | The stimulator will be shut down after 30s of stimulation. The patients will feel the initial itching sensation at the beginning in order to evaluate the placebo effect. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HD-tDCS group | Device | 5 sintered Ag/AgCl ring electrodes will be used at a radius of ~5cm. The electrodes will be placed inside plastic electrode holders which will be filled with gel to have better contact with the scalp. |
| Measure | Description | Time Frame |
|---|---|---|
| Action Research Arm Test (ARAT) | The ARAT has total 19 items, divided into 4 categories (grasp, grip, pinch, and gross arm movement). It ranges from 3 to 0 (best to worse). | 3-month after the 10th session training |
| Measure | Description | Time Frame |
|---|---|---|
| Fugl-Meyer Assessment (Upper Extremity) | The maximum score is 66, divided into 33 items in the form of a 3-point scale (0-2), 0 is cannot perform and 2 performs fully. | 3-month after the 10th session training |
| Wolf Motor Function Test (WMFT) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Raymond Tong, PhD | Department of Biomedical Engineering, CUHK | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Biomedical Engineering, The Chinese University of Hong Kong | Shatin | Hong Kong |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Conventional tDCS group | Device | A pair of 25 cm2 rubber electrodes enclosed in saline-soaked sponges and affixed to the head with rubber bands. |
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| Sham HD-tDCS group | Device | A pair of 25 cm2 rubber electrodes enclosed in saline-soaked sponges and affixed to the head with rubber bands. |
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The WMFT measures upper limb ability through timed and functional tasks. It has 17 items, ranging from 0 to 5 (worse to best).
| 3-month after the 10th session training |
| Magnetic Resonance Imaging | Functional magnetic resonance imaging | Baseline |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |