Transcranial direct current stimulation (tDCS) for improving capacity in activities and arm function after stroke: A network meta-analysis of randomised controlled trials

Abstract Background Transcranial Direct Current Stimulation (tDCS) is an emerging approach for improving capacity in activities of daily living (ADL) and upper limb function after stroke. However, it remains unclear what type of tDCS stimulation is most effective. Our aim was to give an overview of the evidence network regarding the efficacy and safety of tDCS and to estimate the effectiveness of the different stimulation types. Methods We performed a systematic review of randomised trials using network meta-analysis (NMA), searching the following databases until 5 July 2016: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, Web of Science, and four other databases. We included studies with adult people with stroke. We compared any kind of active tDCS (anodal, cathodal, or dual, that is applying anodal and cathodal tDCS concurrently) regarding improvement of our primary outcome of ADL capacity, versus control, after stroke. PROSPERO ID: CRD42016042055. Results We included 26 studies with 754 participants. Our NMA showed evidence of an effect of cathodal tDCS in improving our primary outcome, that of ADL capacity (standardized mean difference, SMDÂ =Â 0.42; 95% CI 0.14 to 0.70). tDCS did not improve our secondary outcome, that of arm function, measured by the Fugl-Meyer upper extremity assessment (FM-UE). There was no difference in safety between tDCS and its control interventions, measured by the number of dropouts and adverse events. Conclusion Comparing different forms of tDCS shows that cathodal tDCS is the most promising treatment option to improve ADL capacity in people with stroke.

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PID https://www.doi.org/10.6084/m9.figshare.c.3879490
PID https://www.doi.org/10.6084/m9.figshare.c.3879490.v1
URL https://research.vumc.nl/en/publications/df47041b-3cbf-4dd7-a55e-5fe89a79635a
URL http://dx.doi.org/10.6084/m9.figshare.c.3879490
URL http://dx.doi.org/10.6084/m9.figshare.c.3879490.v1
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Author Elsner, Bernhard
Author Kwakkel, Gert
Author Kugler, Joachim
Author Mehrholz, Jan
Contributor Amsterdam Movement Sciences - Restoration and Development
Contributor Amsterdam Neuroscience - Neurovascular Disorders
Contributor Rehabilitation medicine
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Collected From Datacite; NARCIS
Hosted By Universiteit van Amsterdam Digital Academic Repository; figshare
Publication Date 2017-09-13
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Country Netherlands
Language English
Resource Type Collection; Other ORP type
keyword FOS: Sociology
keyword FOS: Biological sciences
system:type other
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Source https://science-innovation-policy.openaire.eu/search/other?orpId=dedup_wf_001::a783915d5d73a1a41e4526bc11f9610e
Author jsonws_user
Last Updated 19 December 2020, 10:34 (CET)
Created 19 December 2020, 10:34 (CET)