Efficacy of three types of transcranial direct current stimulation in patients with upper limb hemiparesis after stroke: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

PENG Tong ¹ ,  ZHAO Yaning ¹ , LIU Yao ¹ , ZHANG Wei ^1,2 , ZHENG Guanglei ¹ , YANG Tianhe ¹

1. College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan 603210, P. R. China;
2. Department of Nursing, the Affiliated Hospital of North China University of Science and Technology, Tangshan 603210, P. R. China;

Corresponding author：

ZHAO Yaning, Email: 993241932@qq.com

Keywords：

Stroke; Transcranial direct current stimulation; Btdcs; Atdcs; Ctdcs; Upper limb; Network meta-analysis

DOI：

10.7507/1672-2531.202207123

Video：

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Objective To systematically review the efficacy of three transcranial direct current stimulation protocols (anodal stimulation, cathodal stimulation, and bipolar stimulation) on upper extremity function interventions in stroke patients. Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of three transcranial direct current stimulation protocols on upper extremity function interventions in stroke patients from inception to April 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, the network meta-analysis was performed by using R software and ADDIS software. Results A total of 64 RCTs involving 3 968 patients were included. The results of network meta-analysis showed that, the probability order of the three stimulation methods on FMA-U, MBI, NIHSS score was: anode>bipolar>cathode>control. In addition, the probability order on ARAT and BBT score was: anode>cathode>bipolar>control. Conclusion Current evidence shows that the intervention effect of anodic stimulation on upper limb function of stroke patients may be better. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.

Citation： PENG Tong, ZHAO Yaning, LIU Yao, ZHANG Wei, ZHENG Guanglei, YANG Tianhe. Efficacy of three types of transcranial direct current stimulation in patients with upper limb hemiparesis after stroke: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2022, 22(12): 1436-1444. doi: 10.7507/1672-2531.202207123 Copy

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1. 《中国脑卒中防治报告》编写组. 《中国脑卒中防治报告2020》概要. 中国脑血管病杂志, 2022, 19(2): 136-144.
2. Kramer SF, Hung SH, Brodtmann A. The impact of physical activity before and after stroke on stroke risk and recovery: a narrative review. Curr Neurol Neurosci Rep, 2019, 19(6): 28.
3. Raghavan P. Upper limb motor impairment after stroke. Phys Med Rehabil Clin N Am, 2015, 26(4): 599-610.
4. Gittler M, Davis AM. Guidelines for adult stroke rehabilitation and recovery. JAMA, 2018, 319(8): 820-821.
5. Chase HW, Boudewyn MA, Carter CS, et al. Transcranial direct current stimulation: a roadmap for research, from mechanism of action to clinical implementation. Mol Psychiatry, 2020, 25(2): 397-407.
6. Kim H, Kim J, Lee G, et al. Task-related hemodynamic changes induced by high-definition transcranial direct current stimulation in chronic stroke patients: an uncontrolled pilot fNIRS study. Brain Sci, 2022, 12(4): 453.
7. Alisar DC, Ozen S, Sozay S. Effects of bihemispheric transcranial direct current stimulation on upper extremity function in stroke patients: a randomized double-blind sham-controlled study. J Stroke Cerebrovasc Dis, 2020, 29(1): 104454.
8. Llorens R, Fuentes MA, Borrego A, et al. Effectiveness of a combined transcranial direct current stimulation and virtual reality-based intervention on upper limb function in chronic individuals post-stroke with persistent severe hemiparesis: a randomized controlled trial. J Neuroeng Rehabil, 2021, 18(1): 108.
9. Kim SH. Effects of dual transcranial direct current stimulation and modified constraint-induced movement therapy to improve upper-limb function after stroke: a double-blinded, pilot randomized controlled trial. J Stroke Cerebrovasc Dis, 2021, 30(9): 105928.
10. Chen SC, Yang LY, Adeel M, et al. Transcranial electrostimulation with special waveforms enhances upper-limb motor function in patients with chronic stroke: a pilot randomized controlled trial. J Neuroeng Rehabil, 2021, 18(1): 106.
11. Yao X, Cui L, Wang J, et al. Effects of transcranial direct current stimulation with virtual reality on upper limb function in patients with ischemic stroke: a randomized controlled trial. J Neuroeng Rehabil, 2020, 17(1): 73.
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Chinese Journal of Evidence-Based Medicine

Efficacy of three types of transcranial direct current stimulation in patients with upper limb hemiparesis after stroke: a network meta-analysis

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