Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Brain Injury; Stroke
Objective(s) : To investigate effects of transcranial direct current stimulation (tDCS) on cognitive functioning in traumatic brain injury (TBI) and stroke.
Data Sources : PubMed, Google Scholar, and ClinicalTrials.gov were searched using keywords “Transcranial Direct Current Stimulation”, “Traumatic Brain Injury”, “stroke” and “cognitive function” from 2015-2019. Five peer-reviewed articles were published since the most recent reviews on this topic. In addition, we included preliminary poster presentation findings from a rehabilitation center.
Study Selection : Two independent reviewers selected clinical outcome studies with human subjects evaluating cognition and tDCS following TBI or stroke.
Data Extraction : Data were systemized according to (1) population, (2) comparison groups, (3) setting, (4) experimental and control treatment, (5) outcome measures, (6) analysis, and (7) results.
Data Synthesis : Findings on the impact of tDCS on cognition in TBI and stroke are mixed. Compared to sham stimulation, tDCS applied to the dorsolateral prefrontal cortex (DLPFC) was shown to improve attention on a reaction time task. Other studies have found similar improvements in auditory memory in both healthy controls and TBI patients, or no differences between groups. In the stroke population, one study indicated that tDCS to the DLPFC was associated with improved performance on attention and concentration, logical reasoning, and ratings of disability.
Conclusions : The current review investigates the most recent findings of the clinical utility of tDCS in TBI and stroke. Results of previous studies may be conflicting due to differences in number of sessions of tDCS, duration since sustaining TBI or stroke, and outcome measures used. tDCS is noninvasive, easily administered, and relatively low cost, and has potential for clinical application and recovery during rehabilitation.
Maggie Abraham– Graduate Student, Rosalind Franklin University of Medicine and Science, Chicago, Illinois
Natasha Poulopoulos– Intern, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
Eric Larson– Director, Psychology and Brain Injury, Marianjoy Rehabilitation Hospital, part of Northwestern Medicine, Wheaton, Illinois