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Towards a personalized approach to motor recovery after stroke with transcranial direct current stimulation (tDCS)

Grant number: 18/04544-9
Support Opportunities:Scholarships abroad - Research
Effective date (Start): August 13, 2018
Effective date (End): July 12, 2019
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Sandra Regina Alouche
Grantee:Sandra Regina Alouche
Host Investigator: Mindy Levin
Host Institution: Pró-Reitoria de Pós-Graduação, Pesquisa e Extensão. Universidade Cidade de São Paulo (UNICID). São Paulo , SP, Brazil
Research place: McGill University, Montreal, Canada  


Introduction: Functional incapacity after stroke related to the upper limb function remains in 75% of cases. The application of transcranial direct current stimulation (tDCS) influences neuroplasticity and functional recovery. Its use is still controversial because of the response variability between individuals and the lack of a standardized tDCS protocol. Objective: To investigate how the severity of the stroke and stimulation parameters influence the individual motor responses during the tDCS. Method: Patients with subacute stroke will practice aiming movements during physical therapy. At the same time they will receive three types of tDCS (anodal, catodal and sham), each one applied on a different day, separated by rest periods. The tDCS will be applied in the non-affected motor cortex by injury. The primary outcomes will be obtained by kinematic analysis of the reaching movements of the upper limb performed before and after each session of tDCS + rehabilitation and 24 hrs after. Functional magnetic resonance will be used to quantify the severity of corticospinal tract injury. Expected results: This project aims to elucidate what kind of tDCS will optimize motor learning for each patient. Work plan: The participation in this research project will allow that the expertise in various areas of knowledge be brought to Brazil and implemented in studies and in physiotherapy practice. Specifically, in: application of tDCS and its usage as a physiotherapeutic approach; analysis of magnetic resonance and the degree of the corticospinal tract lesion as a biomarker; kinematic analysis of the reaching movements; and procedures for rehabilitation in individuals post-stroke. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ALOUCHE, SANDRA R.; MOLAD, RONI; DEMERS, MARIKA; LEVIN, MINDY F.. Development of a Comprehensive Outcome Measure for Motor Coordination; Step 1: Three-Phase Content Validity Process. NEUROREHABILITATION AND NEURAL REPAIR, v. 35, n. 2, p. 185-193, . (18/04544-9)
MOLAD, RONI; ALOUCHE, SANDRA R.; DEMERS, MARIKA; LEVIN, MINDY F.. Development of a Comprehensive Outcome Measure for Motor Coordination, Step 2: Reliability and Construct Validity in Chronic Stroke Patients. NEUROREHABILITATION AND NEURAL REPAIR, v. 35, n. 2, p. 194-203, . (18/04544-9)

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