Evidence map›Paper›PMID 21068427›Full record

Trial reportNeurology2010

Bihemispheric brain stimulation facilitates motor recovery in chronic stroke patients.

R Lindenberg, V Renga, L L Zhu, D Nair, G Schlaug

7 registry-linked trialsOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 245 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
245citing papers in PubMed, 18 pooled it
28.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00792428 nacompletednot on this map

Facilitating Motor Recovery After Stroke Using tDCS

TypeinterventionalSponsorBeth Israel Deaconess Medical CenterRan2006 to 2013Enrolled20ConditionsStroke, Cerebrovascular Accident, CVA, Acute StrokeArmsReal Transcranial Direct Current Stimulation, Sham Transcranial Direct Current Stimulation
NCT01644929 naunknown statusnot on this mapstarted 2013, after this paper: background citation

Rehabilitation Combined With Bihemispherictranscranial Direct Current Stimulation in Subacute Ischemic Stroke to Increase Upper Limb Motor Recovery, a Randomised, Controlled, Double-blind Study

TypeinterventionalSponsorDr. med. Carlo CeredaRan2013 to 2018Enrolled36ConditionsFirst Ever Clinical Stroke, Ischemic Stroke, Subacute Phase, Persistent Hemiparesis of Upper ExtremityArmstranscranial direct current stimulation (tDCS), Sham stimulation, then tDCS, Sham stimulation
NCT01847157 nacompletednot on this mapstarted 2013, after this paper: background citation

The Effect of the Transcranial Direct Current Stimulation Combined Sensory Modulation Intervention on Upper Extremity Functional Rehabilitation in Patients With Chronic Stroke

TypeinterventionalSponsorNational Taiwan University HospitalRan2013 to 2015Enrolled25ConditionsStrokeArmstDCS, Epidermis anesthesia, sham anesthesia, Repeated passive movement, sham tDCS
NCT01969097 nacompletednot on this mapstarted 2012, after this paper: background citation

Efficacy Basics of Bihemispheric Motorcortex Stimulation After Stroke

TypeinterventionalSponsorCharite University, Berlin, GermanyRan2012Enrolled50ConditionsStroke, HemiparesisArmstDCS, Motor training
NCT03839316 nacompletednot on this mapstarted 2017, after this paper: background citation

The Effect of Bihemispheric Transcranial Direct Current Stimulation Therapy on Upper Extremity Motor Functions in Stroke Patients

TypeinterventionalSponsorBaskent UniversityRan2017 to 2019Enrolled32ConditionsStroke, Upper Extremity Paresis, Transcranial Direct Current StimulationArmstDCS, sham tDCS
NCT04244578 nacompletednot on this mapstarted 2016, after this paper: background citation

Transcranial Direct Current Stimulation in the Treatment of Dyslexia: a Randomized Double-blind Study.

TypeinterventionalSponsorBambino Gesù Hospital and Research InstituteRan2016 to 2021Enrolled28ConditionsDyslexiaArmsActive tDCS, Sham tDCS
NCT05832060 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Comparing the Efficacy of tDCS and tRNS to Improve Reading Skills in Children and Adolescents With Dyslexia

TypeinterventionalSponsorBambino Gesù Hospital and Research InstituteRan2023 to 2025Enrolled24ConditionsDevelopmental DyslexiaArmsActive tDCS, Active tRNS, Sham tRNS or tDCS
3 · Its place in the literature

Who cites it

245 citing papers in PubMed, 18 syntheses or guidelines pooled it, 575 citations in OpenAlex.

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  5. Effects of home-based neurostimulation on outcomes after stroke: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
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  7. Comparative efficacy of different noninvasive brain stimulation protocols on upper-extremity motor function and activities of daily living after stroke: a systematic review and network meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
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  12. Transcranial direct current stimulation for improving ambulation after stroke: a systematic review and meta-analysis.International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation · 2020
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185 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

R LindenbergDepartment of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA. gschlaug@bidmc.harvard.edu
V Renga
L L Zhu
D Nair
G Schlaug
Beth Israel Deaconess Medical Center · USHarvard University · US

Funding

Behavioral and Neural Correlates of Melodic Intonation TherapyR01DC008796 · NIDCD · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SCHLAUG, GOTTFRIED · 2008 to 2012
$2.0M
Neural Control of Vocal Production in Tone-DeafnessR01DC009823 · NIDCD · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SCHLAUG, GOTTFRIED · 2009 to 2013
$1.7M
Facilitators of Motor Recovery Following StrokeR01NS045049 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SCHLAUG, GOTTFRIED · 2004 to 2007
$1.3M
NIDCD NIH HHS 1R01 DC008796NIDCD NIH HHS R01 DC009823NIDCD NIH HHS R01 DC009823-01NINDS NIH HHS 1R01NS045049NINDS NIH HHS NS045049NINDS NIH HHS R01 NS045049
6 · The paper itself

Abstract

objectiveMotor recovery after stroke depends on the integrity of ipsilesional motor circuits and interactions between the ipsilesional and contralesional hemispheres. In this sham-controlled randomized trial, we investigated whether noninvasive modulation of regional excitability of bilateral motor cortices in combination with physical and occupational therapy improves motor outcome after stroke.

methodsTwenty chronic stroke patients were randomly assigned to receive 5 consecutive sessions of either 1) bihemispheric transcranial direct current stimulation (tDCS) (anodal tDCS to upregulate excitability of ipsilesional motor cortex and cathodal tDCS to downregulate excitability of contralesional motor cortex) with simultaneous physical/occupational therapy or 2) sham stimulation with simultaneous physical/occupational therapy. Changes in motor impairment (Upper Extremity Fugl-Meyer) and motor activity (Wolf Motor Function Test) assessments were outcome measures while functional imaging parameters were used to identify neural correlates of motor improvement.

resultsThe improvement of motor function was significantly greater in the real stimulation group (20.7% in Fugl-Meyer and 19.1% in Wolf Motor Function Test scores) when compared to the sham group (3.2% in Fugl-Meyer and 6.0% in Wolf Motor Function Test scores). The effects outlasted the stimulation by at least 1 week. In the real-stimulation group, stronger activation of intact ipsilesional motor regions during paced movements of the affected limb were found postintervention whereas no significant activation changes were seen in the control group.

conclusionsThe combination of bihemispheric tDCS and peripheral sensorimotor activities improved motor functions in chronic stroke patients that outlasted the intervention period. This novel approach may potentiate cerebral adaptive processes that facilitate motor recovery after stroke. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for adult patients with ischemic stroke treated at least 5 months after their first and only stroke, bihemispheric tDCS and simultaneous physical/occupational therapy given over 5 consecutive sessions significantly improves motor function as measured by the Upper Extremity Fugl-Meyer assessment (raw change treated 6.1 ± 3.4, sham 1.2 ± 1.0).

Indexed as

Motor SkillsOccupational TherapyPhysical Therapy ModalitiesAdultAgedChronic DiseaseFemaleFunctional LateralityHumansMaleMiddle AgedMotor CortexNeuronal PlasticityRecovery of FunctionStrokeStroke Rehabilitation

Identifiers

PMID21068427
PMCPMC3013585
OpenAlexW2074762213

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

and 1 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.