ArticleNeurorehabilitation and neural repair2026
Heterogeneous Recruitment Curve Responses to Anodal Transcranial Direct Current Stimulation in Children With Unilateral Spastic Cerebral Palsy.
Article in Neurorehabilitation and neural repair, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Electrotherapy in Pediatric Rehabilitation: A Structured Narrative Review of Clinical Applications, Treatment Parameters, Safety, and Evidence Gaps.Journal of clinical medicine · 2026Review
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Authors and funding
6 authors.
Funding
Abstract
backgroundChildren with unilateral spastic cerebral palsy (USCP) exhibit altered corticospinal organization that may influence responsiveness to treatment. Transcranial direct current stimulation (tDCS) may modulate corticospinal excitability, though responses vary widely. Recruitment curves derived from transcranial magnetic stimulation (TMS) can quantify excitability changes.
objectiveTo evaluate the feasibility, safety, and preliminary effects of combined TMS and anodal tDCS on recruitment curve-derived corticospinal excitability in children with USCP and explore predictors of responsiveness.
methodsIn a single-group pre/post study, 20 children with USCP completed TMS-evoked recruitment curve testing before and after 20 minutes of 2mA anodal tDCS. Primary outcomes included changes in S50 (half-maximal motor-evoked potential [MEP] intensity) and slope at the curve inflection point. Secondary outcomes included MEP amplitude-based and model-derived recruitment curve metrics. Safety and tolerability were assessed using a standardized symptom screen.
resultsThe protocol was well-tolerated: no serious adverse events occurred, 80% reported no symptoms, and the most common symptom was mild scalp itching. No significant group-level pre/post differences were observed in this preliminary study. Responses were heterogeneous: 11/20 children met the responder definition (ΔS50 < 0). Exploratory analyses identified no consistent clinical or neurophysiologic predictors, although a potential responder pattern was observed in participants with bilateral corticospinal tract patterns.
conclusionsAlthough uniform group-level excitability changes were not observed following a single session of 2mA anodal tDCS, recruitment curve metrics were feasible, well-tolerated, and sensitive to interindividual differences. These findings support the use of recruitment curves as feasible tools to characterize variability and inform individualized neuromodulation strategies.
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