A meta-analysis of the efficacy of anodal transcranial direct current stimulation for upper limb motor recovery in stroke survivors

J Hand Ther. 2013 Apr-Jun;26(2):162-70; quiz 171. doi: 10.1016/j.jht.2012.07.002. Epub 2012 Sep 8.

Abstract

Study design: Systematic review and meta-analysis.

Introduction: Prior reviews on the effects of anodal transcranial direct current stimulation (a-tDCS) have shown the effectiveness of a-tDCS on corticomotor excitability and motor function in healthy individuals but nonsignificant effect in subjects with stroke.

Purpose: To summarize and evaluate the evidence for the efficacy of a-tDCS in the treatment of upper limb motor impairment after stroke.

Methods: A meta-analysis of randomized controlled trials that compared a-tDCS with placebo and change from baseline.

Results: A pooled analysis showed a significant increase in scores in favor of a-tDCS (standard mean difference [SMD]=0.40, 95% confidence interval [CI]=0.10-0.70, p=0.010, compared with baseline). A similar effect was observed between a-tDCS and sham (SMD=0.49, 95% CI=0.18-0.81, p=0.005).

Conclusion: This meta-analysis of eight randomized placebo-controlled trials provides further evidence that a-tDCS may benefit motor function of the paretic upper limb in patients suffering from chronic stroke.

Level of evidence: Level 1a.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review
  • Systematic Review

MeSH terms

  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Motor Skills / physiology*
  • Paresis / etiology
  • Paresis / rehabilitation*
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Stroke / complications
  • Stroke Rehabilitation*
  • Survivors
  • Transcranial Magnetic Stimulation / methods*
  • Treatment Outcome
  • Upper Extremity / physiopathology