Transcranial direct current stimulation (tDCS) can enhance the effect of conventional therapies in post-stroke neurorehabilitation. The ability to predict an individual’s potential for tDCS-induced recovery may permit rehabilitation providers to make rational decisions about who will be a good candidate for tDCS therapy. We investigated the clinical and biological characteristics which might predict tDCS plus physical therapy effects on upper limb motor recovery in chronic stroke patients. A cohort of 80 chronic stroke individuals underwent ten to fifteen sessions of tDCS plus physical therapy. The sensorimotor function of the upper limb was assessed by means of the upper extremity section of the Fugl-Meyer scale (UE-FM), before and after treatment. A backward stepwise regression was used to assess the effect of age, sex, time since stroke, brain lesion side, and basal level of motor function on UE-FM improvement after treatment. Following the intervention, UE-FM significantly improved (), and the magnitude of the change was clinically important (mean 6.2 points, 95% CI: 5.2–7.4). The baseline level of UE-FM was the only significant predictor (, , ) of tDCS response. These findings may help to guide clinical decisions according to the profile of each patient. Future studies should investigate whether stroke severity affects the effectiveness of tDCS combined with physical therapy.

中文翻译：

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基线运动损伤可预测经颅直流电刺激与物理治疗相结合对慢性中风患者的改善


经颅直流电刺激（tDCS）可以增强常规疗法在中风后神经康复中的效果。预测个体经颅直流电刺激 (tDCS) 诱导恢复的潜力的能力可能使康复提供者能够就谁是经颅直流电刺激 (tDCS) 治疗的良好候选者做出合理的决定。我们研究了可能预测 tDCS 联合物理治疗对慢性中风患者上肢运动恢复效果的临床和生物学特征。 80 名慢性中风患者接受了 10 到 15 次 tDCS 加物理治疗。治疗前后，通过 Fugl-Meyer 量表（UE-FM）的上肢部分评估上肢的感觉运动功能。采用向后逐步回归评估年龄、性别、中风后时间、脑病变侧和基础运动功能水平对治疗后 UE-FM 改善的影响。干预后，UE-FM 显着改善（ ），并且变化的幅度具有临床重要性（平均 6.2 分，95% CI：5.2-7.4）。 UE-FM 的基线水平是唯一显着的预测因子（ , , ）的 tDCS 响应。这些发现可能有助于根据每位患者的情况指导临床决策。未来的研究应该调查中风严重程度是否影响 tDCS 联合物理治疗的有效性。