Imaging the Effects of Bihemispheric Transcranial Stimulation and Motor Training After Stroke.

Neuroplasticity Following Bihemispheric Transcranial Direct Current Stimulation and Motor Training in Chronic Stroke Patients.

Functional and structural magnetic resonance imaging (MRI) will be used to investigate neural correlates of bihemispheric transcranial direct current stimulation (tDCS) associated with upper limb rehabilitation in chronic stroke patients. For this purpose, patients included will be submitted to 10 sessions with active or sham bihemispheric tDCS associated with intensive and individualized rehabilitation. Neuroimage will be employed before and after the intervention to investigate neural correlates of expected changes in motor function.

Inclusion Criteria:

• Chronic Stroke (> 12 months)
• Upper limb sensorimotor sequelae due to stroke affecting only one cerebral hemisphere
• The structural integrity of the corpus callosum sensorimotor
• Showing ability to perform some movement with the paretic upper limb: at least minimal active mobility of the wrist and two fingers of the paretic hand.
• Score ≥ 18 at Folstein Mini-Mental State Examination

Exclusion Criteria:

• Score ≥ 4 at Ashworth Scale
• MRI or tDCS contraindications (cardiac pacemakers; implanted medication pumps; cochlear, or eye implants; craniotomy, skin lesions at the site of stimulation; surgical clips in or near the brain; claustrophobia, history of seizures, permanent makeup or tattoos with metallic dyes…)
• Prior neurological diseases
• Hemodynamic instability
• Pregnancy
• Traumatic or orthopedic lesion limiting the range of upper limb motion
• Severe comprehension deficits, apraxia or neglect that would interfere with performing the study tasks
• Score > 59 at the Fugl-Meyer Assessment of Motor Recovery after Stroke