Home-based tDCS a safe, feasible poststroke rehabilitation modality
Remotely supervised (RS) transcranial direct current stimulation (tDCS) helps improve cognitive function in stroke survivors, especially those with moderate cognitive decline, according to a study from Korea.
In the study, 26 patients with chronic stroke and cognitive impairment (Korean version of the Montreal Cognitive Assessment [K-MoCA] score <26) were randomized to undergo real or sham RS-tDCS with concurrent computerized cognitive training. All patients and caregivers were trained to ensure correct tDCS self-application, monitored, and treated 5 days weekly for 4 weeks.
Researchers evaluated cognition tests including K-MoCA, Korean version of the Dementia Rating Scale-2, Korean-Boston Naming Test, Trail Making Test, Go/No Go, and Controlled Oral Word Association Test at the end of the training sessions and then 1 month later. They applied repeated-measures ANOVA to compare the outcomes between the groups and within each group. Adherence to RS-tDCS was also assessed.
Within-group comparison showed that unlike the sham group, the real group achieved marked improvements in K-MoCA (preal=0.004 vs psham=0.132), especially patients with lower baseline K-MoCA (K-MoCA 10–17: preal=0.001 vs psham=0.835; K-MoCA 18–25: preal=0.060 vs psham=0.064) or those with left hemispheric lesions (left: preal=0.010 vs psham=0.454; right: preal=0.106 vs psham=0.128).
Between-group comparison confirmed that real vs sham RS-tDCS was associated with significant improvement in K-MoCA in the lower baseline K-MoCA subgroup (K-MoCA 10–17: p=0.048), but not in other cognitive tests.
The adherence rate of successful application of the RS-tDCS was high at 98.4 percent, with no reports of serious adverse effects.