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Transcranial direct current stimulation facilitates motor learning post-stroke: a systematic review and meta-analysis
  1. Nyeonju Kang1,
  2. Jeffery J Summers2,3,
  3. James H Cauraugh1
  1. 1Motor Behavior Laboratory, University of Florida, Gainesville, Florida, USA
  2. 2Human Motor Control Laboratory, University of Tasmania, Hobart, Tasmania, Australia
  3. 3Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
  1. Correspondence to Dr James H Cauraugh, Motor Behavior Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611–8206, USA; cauraugh{at}


Transcranial direct current stimulation (tDCS) is an attractive protocol for stroke motor recovery. The current systematic review and meta-analysis investigated the effects of tDCS on motor learning post-stroke. Specifically, we determined long-term learning effects by examining motor improvements from baseline to at least 5 days after tDCS intervention and motor practise. 17 studies reported long-term retention testing (mean retention interval=43.8 days; SD=56.6 days) and qualified for inclusion in our meta-analysis. Assessing primary outcome measures for groups that received tDCS and motor practise versus sham control groups created 21 valid comparisons: (1) 16 clinical assessments and (2) 5 motor skill acquisition tests. A random effects model meta-analysis showed a significant overall effect size=0.59 (p<0.0001; low heterogeneity, T2=0.04; I2=22.75%; and high classic fail-safe N=240). 4 moderator variable analyses revealed beneficial effects of tDCS on long-term motor learning: (1) stimulation protocols: anodal on the ipsilesional hemisphere, cathodal on the contralesional hemisphere, or bilateral; (2) recovery stage: subacute or chronic stroke; (3) stimulation timing: tDCS before or during motor practise; and (4) task-specific training or conventional rehabilitation protocols. This robust meta-analysis identified novel long-term motor learning effects with tDCS and motor practise post-stroke.


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