Neurophysiological and Behavioral Effects of Combining Transcranial Direct Current Stimulation (tDCS) and Modified-Constraint Induced Movement Therapy (mCIMT) on Upper Limb Function Recovery in Patients with Stroke

What this Trial Is About

Researchers are evaluating the effects of different types of transcranial direct current stimulation (tDCS) combined with modified constraint induced movement therapy (mCIMT) on improving upper limb motor function in patients who have experienced a stroke. The study aims to determine which type of tDCS—bi-hemispheric, anodal, or cathodal—along with mCIMT leads to the greatest improvement compared to a sham tDCS treatment. This trial focuses on adults who have had ischemic or hemorrhagic strokes with unilateral motor deficits and are cognitively able to follow instructions. Participants will be randomly assigned to one of four groups: anodal tDCS with mCIMT, cathodal tDCS with mCIMT, bi-hemispheric tDCS with mCIMT, or mCIMT alone with sham tDCS. Each session includes 20 minutes of the assigned tDCS type followed by one hour of mCIMT exercises involving twelve different tasks. The sessions are conducted three times a week over four weeks, totaling 12 treatment sessions. The tDCS electrodes are placed over specific brain areas depending on the assigned group to modulate cortical excitability. During the study, participants will undergo motor and physiological assessments at baseline, after two weeks, and after the full four-week intervention. Measurements include motor function tests such as the Fugl-Meyer Assessment, Wolf Motor Function Test, and Nine-Hole Peg Test. Brain activity and excitability will be evaluated using functional MRI and transcranial magnetic stimulation. Safety and adherence will be monitored throughout, with additional assessments of stroke impact and exercise adherence. The total participation spans the four-week intervention period with multiple evaluations.

Neurophysiological and Behavioral Effects of Combining Transcranial Direct Current Stimulation (tDCS) and Modified-Constraint Induced Movement Therapy (mCIMT)