Title : Comparison of motor function effects according to tDCS application methods in cerebellar stroke patients
Abstract:
Objectives: Transcranial electric stimulation is known to improve motor learning. Recently, a study on the combination of tDCS and upper limb rehabilitation robot treatment has been conducted, but the evidence for the effect is insufficient. In particular, such studies have not been studied in stroke patients with cerebellar lesions. The purpose of this study was to examine the effects of tDCS on upper limb motor function in patients with cerebellar stroke.
Materials and methods: The upper limb rehabilitation robot used armeo spring (Hocoma Inc, Zurich, Switzerland). Noninvasive transcranial electrostimulation was performed using transcranial direct current stimulation(tDCS) of DC-stimulator. Twenty-six participants were randomly divided two groups: real tDCS(on-line) or sham tDCS. The active electrode attached to the skin over one ipsilateral (more effective) cerebellar hemisphere at 1-2 cm below and 3-4 cm lateral to the inion and the reference electrode attached to the ipsilateral buccinators muscle (more affected). tDCS was set in study mode and the intensity of stimulus was set to 2mA, fade in and out were set to 5 seconds each, and simulation time was set to 20 minutes. Intervention was conducted 20 times for 4 weeks, 30 minutes a day, 5 days a week. Both groups applied the same upper limb robot therapy. In this study, upper extremity functional assessment was performed before and after intervention with Fugl-Meyer Assessment- upper extremity (FMA), composite cerebellar functional severity (CCFS), scale of the assessment and rating of ataxia (SARA) and functional ataxia rating scale_upper limb (FARS). For statistical analysis, Mann-Whitney's U test and Wilcoxon test were used.
Results: In the real tDCS group, the total score of FMA was significantly improved after the intervention than before the intervention, and there was a statistically significant difference(p<0.05). In addition, the CCFS assessment of coordination, both groups showed significant differences in function after intervention than before intervention(p<0.05).
Conclusions: A statistically significant difference appeared in the real tDCS group, indicating that it was effective for the motor function. However, this did not show any significance between groups. This requires more detailed statistical analysis between groups.
