Affiliations: [a]
Burke Medical Research Institute, White Plains, NY, USA
| [b] Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, NY, USA
| [c]
Universitat de Barcelona, Barcelona, Spain
| [d] Nervous System Electric Stimulation Laboratory, Rio de Janeiro State University, Brazil
| [e] Newman Laboratory for Biomechanics and Human Rehabilitation, Massachusetts Institute of Technology (MIT), Cambridge, MA, USA
| [f] Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| [g] School of Medical and Health sciences, Edith Cowan University, Joondalup, WA, Australia
Correspondence:
[*]
Address for correspondence: Mar Cortes, Human Spinal Cord Injury Repair Laboratory, Burke Medical Research Institute, 785 Mamaroneck Avenue, White Plains, NY 10605, USA. Tel.: +1 914 3683181; Fax: +1 914 597 2796; E-mail: [email protected].
Abstract: BACKGROUND: Recovering hand function has important implications for improving independence of patients with tetraplegia after traumatic spinal cord injury (SCI). Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique that has potential to improve motor function. OBJECTIVE: To investigate the effects of one session of 1 mA, 2 mA, and sham anodal tDCS (a-tDCS) in the upper extremity (hand) motor performance (grasp and lease) in patients with chronic cervical SCI. METHODS: Eleven participants with incomplete SCI were randomized to receive 20 minutes of 1 mA, 2 mA, or sham stimulation over the targeted motor cortex over three separated sessions. Hand motor performance was measured by a hand robotic evaluation (kinematics) and the Box and Blocks (BB) test before and after the stimulation period. RESULTS: A significant improvement on the grasp mean to peak speed ratio (GMP) was observed in the 2 mA group (pre: 0.38±0.02; post: 0.43±0.03; mean±SEM; p = 0.031). There was no statistically significant difference in BB test results, however the 2 mA intervention showed a positive trend for improvement. CONCLUSIONS: A single session of 2 mA of a-tDCS showed gains in hand motor function in patients with chronic SCI that were not observed in functional clinical scales. The use of robotic kinematics showed promising results in assessing small changes in motor performance. Further studies are necessary to determine whether tDCS can be an effective long-term rehabilitation strategy for individuals with SCI.
Keywords: tDCS, hand robot, motor recovery, spinal cord injury
