Evidence map›Paper›PMID 26433609›Full record

SynthesisBrain stimulation

Transcranial Direct Current Stimulation Post-Stroke Upper Extremity Motor Recovery Studies Exhibit a Dose-Response Relationship.

Pratik Y Chhatbar, Viswanathan Ramakrishnan, Steven Kautz, Mark S George, Robert J Adams, Wuwei Feng

2 registry-linked trialsAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Brain stimulation. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 81 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
81citing papers in PubMed, 17 pooled it
–field-weighted citation impact
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.

NCT03839316 nacompletednot on this map

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
NCT04291573 nacompletednot on this map

Recovering Arm Function in Chronic Post-stroke Patients Using Combined HD-tDCS and Virtual Reality Therapy

TypeinterventionalSponsorUniversity Hospital, MontpellierRan2021 to 2025Enrolled58ConditionsChronic Post Stroke IndividualsArmsHD-tDCS, Sham HD-tDCS
3 · Its place in the literature

Who cites it

81 citing papers in PubMed, 17 syntheses or guidelines pooled it.

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  5. Efficacy of transcranial direct current stimulation in patients with dysphagia after stroke: a systematic review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
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  11. 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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  18. Trial
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  20. Volumetric analysis of the damage and response of non-invasive brain stimulation in patients with spatial neglect after stroke: a subgroup analysis of the ELETRON trial.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2025
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21 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Pratik Y ChhatbarDepartment of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Viswanathan RamakrishnanDepartment of Public Health Science, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Steven KautzDepartment of Health Science & Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA.
Mark S GeorgeRalph H. Johnson VA Medical Center, Charleston, SC, USA; Department of Psychiatry and Behavioral Science, Brain Stimulation Laboratory, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Robert J AdamsDepartment of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Wuwei FengDepartment of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Department of Health Science & Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA. Electronic address: feng@musc.edu.

Funding

Treating Depression and Enhancing Locomotor Recovery Post-strokeP20GM109040 · NIGMS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI KAUTZ, STEVEN A. · 2014 to 2024
$23.5M
NIGMS NIH HHS P20 GM109040NIGMS NIH HHS P20GM109040
6 · The paper itself

Abstract

background and purposeTranscranial direct current stimulation (tDCS) has shown mixed results in post-stroke motor recovery, possibly because of tDCS dose differences. The purpose of this meta-analysis was to explore whether the outcome has a dose-response relationship with various dose-related parameters.

methodsThe literature was searched for double-blind, randomized, sham-controlled clinical trials investigating the role of tDCS (≥5 sessions) in post-stroke motor recovery as measured by the Fugl-Meyer Upper Extremity (FM-UE) scale. Improvements in FM-UE scores were compared between active and sham groups by calculating standardized mean differences (Hedge's g) to derive a summary effect size. Inverse-variance-weighted linear meta-regression across individual studies was performed between various tDCS parameters and Hedge's g to test for dose-response relationships.

resultsEight studies with total of 213 stroke subjects were included. Summary Hedge's g was statistically significant in favor of the active group (Hedge's g = 0.61, p = 0.02) suggesting moderate effect. Specifically, studies that used bihemispheric tDCS montage (Hedge's g = 1.30, p = 0.08) or that recruited chronic stroke patients (Hedge's g = 1.23, p = 0.02) showed large improvements in the active group. A positive dose-response relationship was found with current density (p = 0.017) and charge density (p = 0.004), but not with current amplitude. Moreover, a negative dose-response relationship was found with electrode size (p < 0.001, smaller electrodes were more effective).

conclusionsOur meta-analysis and meta-regression results suggest superior motor recovery in the active group when compared to the sham group and dose-response relationships relating to electrode size, charge density and current density. These results need to be confirmed in future dedicated studies.

Indexed as

Stroke RehabilitationTranscranial Direct Current StimulationAgedHumansRecovery of FunctionStrokeUpper ExtremityDose–response relationshipHedge's gMeta-analysisMeta-regressionMotor recoveryStroketDCSTranscranial direct current stimulation

Identifiers

PMID26433609
PMCPMC4724265

What OpenQuestion holds

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Registered trials

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.