Annals of Rehabilitation Medicine

"Transcranial direct current stimulation (tDCS)"

Original Articles

Comparison of Repetitive Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation on Upper Limb Recovery Among Patients With Recent Stroke: Ka Ying Doris Miu, Ching Kok, Sau Shan Leung, Elaine Y. L. Chan, Elaine Wong; Ann Rehabil Med 2020;44(6):428-437. Published online December 31, 2020; DOI: https://doi.org/10.5535/arm.20093

Abstract
PDF

Objective
To compare the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on upper limb function recovery among patients who recently had stroke.
Methods
Subjects with recent stroke (within 1 month) were randomized to rTMS (n=25) and tDCS (n=26) applied over the non-lesioned hemisphere for three sessions per week, followed by tailored upper limb rehabilitation training for a total of 2 weeks. The primary outcomes were changes in the Motor Assessment Scale (MAS), Fugl-Meyer arm score test, Nine-Hole Peg Test (9HPT), hand grip strength, and modified Barthel Index at weeks 2 and 4. Both therapists responsible for training and assessment were blinded to the intervention allocated.
Results
There was an improvement in all the motor performance scales among both groups (p<0.001). These improvements persisted at discharge. However, there was no significant difference in any of the assessment scales between the two groups. The rTMS group showed a statistically non-significant greater improvement in MAS, 9HPT, and handgrip strength than the tDCS group.
Conclusion
Both interventions produce a statistically significant improvement in upper limb function. There was no statistically significant difference between the two intervention methods with respect to motor performance. It is suggested that a larger study may help to clarify the superiority of either methods.

Citations

Citations to this article as recorded by

A protocol to optimize non-invasive brain stimulation for post-stroke rehabilitation
Ayesha Juhi, Manul Das, Dinesh Bhatia, Suman Dhaka, Rajesh Kumar, Deepak Kumar, Shreya Sharma, Pritam Kumar Chaudhary, Chanchal Goyal, Md Asif Khan, Himel Mondal
MethodsX.2025; 14: 103209. CrossRef
Comparison of the efficacy of different protocols of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function, activities of daily living, and neurological function in patients with early stroke: a systema
Xueyi Ni, Zinan Yuan, Ruimou Xie, Xiaoxue Zhai, Xiang Cheng, Yu Pan
Neurological Sciences.2025; 46(6): 2479. CrossRef
A Multi-Electrode Transcranial Direct Current Stimulator (ME-tDCS): Design considerations and safety aspects
Cassandra Solomons, Vivekanandan Shanmugasundaram, Sivasakthi Murugan Velayutham
Heliyon.2025; 11(7): e43039. CrossRef
Non-invasive brain stimulation for functional recovery in animal models of stroke: A systematic review
Antonio Rodríguez, Laura Amaya-Pascasio, María Gutiérrez-Fernández, José García-Pinteño, Margarita Moreno, Patricia Martínez-Sánchez
Neuroscience & Biobehavioral Reviews.2024; 156: 105485. CrossRef
The Application of tDCS to Treat Pain and Psychocognitive Symptoms in Cancer Patients: A Scoping Review
Benedetta Capetti, Lorenzo Conti, Chiara Marzorati, Roberto Grasso, Roberta Ferrucci, Gabriella Pravettoni, J. Michael Wyss
Neural Plasticity.2024; 2024: 1. CrossRef
Gamma oscillations induced by 40-Hz visual-auditory stimulation for the treatment of acute-phase limb motor rehabilitation after stroke: study protocol for a prospective randomized controlled trial
Wang Fu, Xiaoming Yu, Minghui Lai, Yuanli Li, Yingting Yang, Yong Qin, Min Yu, Feng Wang, Cong Wang
Trials.2024;[Epub] CrossRef
Molecular Changes in the Ischemic Brain as Non-Invasive Brain Stimulation Targets—TMS and tDCS Mechanisms, Therapeutic Challenges, and Combination Therapies
Aleksandra Markowska, Beata Tarnacka
Biomedicines.2024; 12(7): 1560. CrossRef
Repetitive Transcranial Magnetic Stimulation Coupled With Visual‐Feedback Cycling Exercise Improves Walking Ability and Walking Stability After Stroke: A Randomized Pilot Study
Yixiu Wang, Xiaoming Chen, Menghuan Wang, Yingying Pan, Shiyi Li, Mengfei He, Feng Lin, Zhongli Jiang, Zhiyong Zhao
Neural Plasticity.2024;[Epub] CrossRef
Noninvasive Brain Stimulation for Cancer Pain Management in Nonbrain Malignancy: A Meta-Analysis
Yung-Jiun Chien, Chun-Yu Chang, Meng-Yu Wu, Yung-Chen Chien, Hsin-Chi Wu, Yi-Shiung Horng, Saskia F. A. Duijts
European Journal of Cancer Care.2023; 2023: 1. CrossRef
Exploring the Potential of Transcranial Direct Current Stimulation for Relieving Central Post-Stroke Pain: A Randomized Controlled Pilot Study
Ji-Soo Baik, Jung-Hyun Yang, Sung-Hwa Ko, So-Jung Lee, Yong-Il Shin
Life.2023; 13(5): 1172. CrossRef
Effect of Cathodal Transcranial Direct Current Stimulation for Lower Limb Subacute Stroke Rehabilitation
Qian Duan, Wenying Liu, Jinhui Yang, Ben Huang, Jie Shen, Laura Baroncelli
Neural Plasticity.2023; 2023: 1. CrossRef
A blended neurostimulation protocol to delineate cortico-muscular and spino-muscular dynamics following neuroplastic adaptation
Filip Stefanovic, Julian A. Martinez, Ghazala T. Saleem, Sue Ann Sisto, Michael T. Miller, Yaa A. Achampong, Albert H. Titus
Frontiers in Neurology.2023;[Epub] CrossRef
Non-invasive Brain Stimulation Techniques for the Improvement of Upper Limb Motor Function and Performance in Activities of Daily Living After Stroke: A Systematic Review and Network Meta-analysis
Ishtiaq Ahmed, Rustem Mustafaoglu, Simone Rossi, Fatih A. Cavdar, Seth Kwame Agyenkwa, Marco Y.C. Pang, Sofia Straudi
Archives of Physical Medicine and Rehabilitation.2023; 104(10): 1683. CrossRef
Investigation of the efficacy of low-frequency repetitive transcranial magnetic stimulation on upper-limb motor recovery in subacute ischemic stroke without cortical involvement: a protocol paper for a multi-center, double-blind randomized controlled tria
Hee-Mun Cho, Seungwoo Cha, Min Kyun Sohn, Sungju Jee, Won Kee Chang, Won-Seok Kim, Nam-Jong Paik
Frontiers in Neurology.2023;[Epub] CrossRef
Non-invasive brain stimulation associated mirror therapy for upper-limb rehabilitation after stroke: Systematic review and meta-analysis of randomized clinical trials
Qingqing Zhao, Hong Li, Yu Liu, Haonan Mei, Liying Guo, Xianying Liu, Xiaolin Tao, Jiang Ma
Frontiers in Neurology.2022;[Epub] CrossRef
Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery
Helene Luise Walter, Anton Pikhovych, Heike Endepols, Steffen Rotthues, Johannes Bärmann, Heiko Backes, Mathias Hoehn, Dirk Wiedermann, Bernd Neumaier, Gereon Rudolf Fink, Maria Adele Rueger, Michael Schroeter
Neurorehabilitation and Neural Repair.2022; 36(10-11): 701. CrossRef
Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis
Tao Xue, Zeya Yan, Jiahao Meng, Wei Wang, Shujun Chen, Xin Wu, Feng Gu, Xinyu Tao, Wenxue Wu, Zhouqing Chen, Yutong Bai, Zhong Wang, Jianguo Zhang
Journal of Clinical Medicine.2022; 11(20): 6162. CrossRef

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Interhemispheric Modulation of Dual-Mode, Noninvasive Brain Stimulation on Motor Function: Eunhee Park, Yun-Hee Kim, Won Hyuk Chang, Tae Gun Kwon, Yong-Il Shin; Ann Rehabil Med 2014;38(3):297-303. Published online June 26, 2014; DOI: https://doi.org/10.5535/arm.2014.38.3.297

Abstract
PDF

Objective

To investigate the effects of simultaneous, bihemispheric, dual-mode stimulation using repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on motor functions and cortical excitability in healthy individuals.

Methods

Twenty-five healthy, right-handed volunteers (10 men, 15 women; mean age, 25.5 years) were enrolled. All participants received four randomly arranged, dual-mode, simultaneous stimulations under the following conditions: condition 1, high-frequency rTMS over the right primary motor cortex (M1) and sham tDCS over the left M1; condition 2, high-frequency rTMS over the right M1 and anodal tDCS over the left M1; condition 3, high-frequency rTMS over the right M1 and cathodal tDCS over the left M1; and condition 4, sham rTMS and sham tDCS. The cortical excitability of the right M1 and motor functions of the left hand were assessed before and after each simulation.

Results

Motor evoked potential (MEP) amplitudes after stimulation were significantly higher than before stimulation, under the conditions 1 and 2. The MEP amplitude in condition 2 was higher than both conditions 3 and 4, while the MEP amplitude in condition 1 was higher than condition 4. The results of the Purdue Pegboard test and the box and block test showed significant improvement in conditions 1 and 2 after stimulation.

Conclusion

Simultaneous stimulation by anodal tDCS over the left M1 with high-frequency rTMS over the right M1 could produce interhemispheric modulation and homeostatic plasticity, which resulted in modulation of cortical excitability and motor functions.

Citations

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Transcranial Direct Current Stimulation Combined With Repetitive Transcranial Magnetic Stimulation for Depression
Dongsheng Zhou, Xingxing Li, Shuochi Wei, Chang Yu, Dongmei Wang, Yuchen Li, Jiaxin Li, Junyao Liu, Shen Li, Wenhao Zhuang, Yanli Li, Ruichenxi Luo, Zhiwang Liu, Jimeng Liu, Yongming Xu, Jialin Fan, Guidong Zhu, Weiqian Xu, Yiping Tang, Raymond Y. Cho, Th
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Hui Chang, Yixuan Sheng, Jinbiao Liu, Hongyu Yang, Xiangyu Pan, Honghai Liu
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rTMS combined with motor training changed the inter-hemispheric lateralization
Jing-na Jin, Xin Wang, Ying Li, He Wang, Zhi-peng Liu, Tao Yin
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Neuromodulation in the restoration of function after spinal cord injury
Nicholas D James, Stephen B McMahon, Edelle C Field-Fote, Elizabeth J Bradbury
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The Persisted Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation to Augment Task-Specific Induced Hand Recovery Following Subacute Stroke: Extended Study
Jarugool Tretriluxana, Jenjira Thanakamchokchai, Chutima Jalayondeja, Narawut Pakaprot, Suradej Tretriluxana
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Effect of Dual-Mode and Dual-Site Noninvasive Brain Stimulation on Freezing of Gait in Patients With Parkinson Disease
Won Hyuk Chang, Min Soo Kim, Eunhee Park, Jin Whan Cho, Jinyoung Youn, Yun Kwan Kim, Yun-Hee Kim
Archives of Physical Medicine and Rehabilitation.2017; 98(7): 1283. CrossRef
Can neurophysiologic measures serve as biomarkers for the efficacy of repetitive transcranial magnetic stimulation treatment of major depressive disorder?
Brian Kobayashi, Ian A. Cook, Aimee M. Hunter, Michael J. Minzenberg, David E. Krantz, Andrew F. Leuchter
International Review of Psychiatry.2017; 29(2): 98. CrossRef
High-definition transcranial direct current stimulation to both primary motor cortices improves unimanual and bimanual dexterity
Nils H. Pixa, Fabian Steinberg, Michael Doppelmayr
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Novel Neuromodulation Techniques to Assess Interhemispheric Communication in Neural Injury and Neurodegenerative Diseases
Samuel S. Shin, Galit Pelled
Frontiers in Neural Circuits.2017;[Epub] CrossRef
Dual-mode noninvasive brain stimulation over the bilateral primary motor cortices in stroke patients
Jae Yong Cho, Ahee Lee, Min Su Kim, Eunhee Park, Won Hyuk Chang, Yong-Il Shin, Yun-Hee Kim
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The effects of anodal-tDCS on corticospinal excitability enhancement and its after-effects: conventional vs. unihemispheric concurrent dual-site stimulation
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