Unihemispheric Dual-site Anodal tDCS for Lower Limb Motor Function in Chronic Stroke Patients: A Randomized Clinical Trial

Background: A cerebrovascular accident results in behavioral deficits as a result of damage to the brain’s systems. The motor system is one of the most commonly affected nervous systems. Lower limb motor function is important to a person’s functional independence. Therefore, restoring lower limb mot...

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Main Authors: Somaye Azarnia, kamran Ezzati, Alia Saberi, Yaser Moaddabi, Babak Bakhshayesh Eghbali
Format: Article
Language:English
Published: Guilan University of Medical Sciences 2025-04-01
Series:Caspian Journal of Neurological Sciences
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Online Access:http://cjns.gums.ac.ir/article-1-753-en.pdf
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author Somaye Azarnia
kamran Ezzati
Alia Saberi
Yaser Moaddabi
Babak Bakhshayesh Eghbali
author_facet Somaye Azarnia
kamran Ezzati
Alia Saberi
Yaser Moaddabi
Babak Bakhshayesh Eghbali
author_sort Somaye Azarnia
collection DOAJ
description Background: A cerebrovascular accident results in behavioral deficits as a result of damage to the brain’s systems. The motor system is one of the most commonly affected nervous systems. Lower limb motor function is important to a person’s functional independence. Therefore, restoring lower limb motor function can be an important goal in rehabilitating patients after stroke. Scientists have shown the effects of non-invasive brain stimulation, such as tDCS, in improving the performance of stroke patients. Recently, researchers have proposed that unihemispheric dual-site anodal transcranial direct current stimulation (UHCDS a-tDCS) targeting the primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) could improve the effectiveness of a-tDCS in stroke rehabilitation. Objectives: This study aimed to examine the effect of simultaneous stimulation of two points on the function of the lower limbs of stroke patients. Materials & Methods:  This was a double-blind, randomized clinical trial. The study included 18 patients who had experienced their first chronic stroke. Participants were assigned to either experimental group 1 or group 2, with both undergoing 5 consecutive sessions of a-tDCS. In experimental group 1, patients received active a-tDCS targeting both the M1 and DLPFC, while in experimental group 2, patients received a-tDCS to the M1 and sham stimulation to the DLPFC. Lower limb motor function was assessed using the Fugl-Meyer and time up-and-go test. Assessments were made before and after 5 sessions. Results: The results indicate that following 5 sessions of a-tDCSM1-DLPFC, mobility and functional strength are better than a-tDCSM1 (P=0.04 and P=0.07). Conclusion: Dual site stimulation a-tDCSM1-DLPFC can further improve balance in patients with chronic stroke.
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spelling doaj-art-4095cb4e71b84646bfd0909bf14f357c2025-08-20T03:17:35ZengGuilan University of Medical SciencesCaspian Journal of Neurological Sciences2423-48182025-04-01112172179Unihemispheric Dual-site Anodal tDCS for Lower Limb Motor Function in Chronic Stroke Patients: A Randomized Clinical TrialSomaye Azarnia0kamran Ezzati1Alia Saberi2Yaser Moaddabi3Babak Bakhshayesh Eghbali4 Department of Physiotherapy, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Department of Physiotherapy, Neuroscience Research Center, School of Medicine, Trauma Institute, Poorsina Hospital, Guilan University of Medical Sciences, Rasht, Iran. Department of Neurology, Neuroscience Research Center, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Guilan, Iran Department of Neurology, Faculty of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran. Department of Physiotherapy, Neuroscience Research Center, School of Medicine, Trauma Institute, Poorsina Hospital, Guilan University of Medical Sciences, Rasht, Iran. Background: A cerebrovascular accident results in behavioral deficits as a result of damage to the brain’s systems. The motor system is one of the most commonly affected nervous systems. Lower limb motor function is important to a person’s functional independence. Therefore, restoring lower limb motor function can be an important goal in rehabilitating patients after stroke. Scientists have shown the effects of non-invasive brain stimulation, such as tDCS, in improving the performance of stroke patients. Recently, researchers have proposed that unihemispheric dual-site anodal transcranial direct current stimulation (UHCDS a-tDCS) targeting the primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) could improve the effectiveness of a-tDCS in stroke rehabilitation. Objectives: This study aimed to examine the effect of simultaneous stimulation of two points on the function of the lower limbs of stroke patients. Materials & Methods:  This was a double-blind, randomized clinical trial. The study included 18 patients who had experienced their first chronic stroke. Participants were assigned to either experimental group 1 or group 2, with both undergoing 5 consecutive sessions of a-tDCS. In experimental group 1, patients received active a-tDCS targeting both the M1 and DLPFC, while in experimental group 2, patients received a-tDCS to the M1 and sham stimulation to the DLPFC. Lower limb motor function was assessed using the Fugl-Meyer and time up-and-go test. Assessments were made before and after 5 sessions. Results: The results indicate that following 5 sessions of a-tDCSM1-DLPFC, mobility and functional strength are better than a-tDCSM1 (P=0.04 and P=0.07). Conclusion: Dual site stimulation a-tDCSM1-DLPFC can further improve balance in patients with chronic stroke.http://cjns.gums.ac.ir/article-1-753-en.pdftranscranial direct current stimulationmotor functionstrokelower limb
spellingShingle Somaye Azarnia
kamran Ezzati
Alia Saberi
Yaser Moaddabi
Babak Bakhshayesh Eghbali
Unihemispheric Dual-site Anodal tDCS for Lower Limb Motor Function in Chronic Stroke Patients: A Randomized Clinical Trial
Caspian Journal of Neurological Sciences
transcranial direct current stimulation
motor function
stroke
lower limb
title Unihemispheric Dual-site Anodal tDCS for Lower Limb Motor Function in Chronic Stroke Patients: A Randomized Clinical Trial
title_full Unihemispheric Dual-site Anodal tDCS for Lower Limb Motor Function in Chronic Stroke Patients: A Randomized Clinical Trial
title_fullStr Unihemispheric Dual-site Anodal tDCS for Lower Limb Motor Function in Chronic Stroke Patients: A Randomized Clinical Trial
title_full_unstemmed Unihemispheric Dual-site Anodal tDCS for Lower Limb Motor Function in Chronic Stroke Patients: A Randomized Clinical Trial
title_short Unihemispheric Dual-site Anodal tDCS for Lower Limb Motor Function in Chronic Stroke Patients: A Randomized Clinical Trial
title_sort unihemispheric dual site anodal tdcs for lower limb motor function in chronic stroke patients a randomized clinical trial
topic transcranial direct current stimulation
motor function
stroke
lower limb
url http://cjns.gums.ac.ir/article-1-753-en.pdf
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