Improvement of Hand Function with Transcranial Direct Current Brain Polarization in Stroke Patients.

, Ko, Myoung Hwan; , Han, Sang Hyoung; , Park, Sung Hee; , Seo, Jeong Hwan

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2009;33(3):259-264.

Ko, Myoung Hwan , Han, Sang Hyoung , Park, Sung Hee , Seo, Jeong Hwan

¹Department of Physical Medicine and Rehabilitation and Institute for Medical Sciences, Chonbuk National University Medical School, Korea. dynohero@hanmail.net
²Research Institute of Clinical Medicine, Chonbuk National University Hospital, Korea.

뇌졸중 환자에서 경두개 직류전류 자극에 의한 손 기능 호전

고명환, 한상형, 박성희, 서정환

전북대학교 의학전문대학원 재활의학교실 및 의과학연구소, 전북대학교병원 임상의학연구소

Abstract

Objective
To investigate therapeutic effects of anodal direct current (DC) polarization on the primary motor cortex in subacute and chronic stroke patients by measuring changes of hand function and corticospinal excitability before and after stimulation.
Method
Fourteen subacute and chronic stroke patients were included in this study. This study was designed as a sham-controlled, double-blind, and crossover experiment. The anode was positioned on the primary motor cortex of the affected hemisphere. The primary motor cortex was identified using transcranial magnetic stimulation (TMS), the motor evoked potentials (MEPs) were recorded by surface electrodes placed over the contralateral first dorsal interosseous muscle. DC was delivered for 20 minute at 2 mA with 25 cm² saline-soaked sponge electrodes. Before and after DC polarization, we checked the box and block test, nine hole peg test, grip power, lateral prehension power, MEPs amplitude, and MEPs latency.
Results
The box and block test, grip power, lateral prehension power, and MEPs amplitude increased after anodal DC to primary motor cortex (p＜0.05). Positive correlation showed between improvement of box and block test and change of MEPs amplitude (r=0.808, p=0.001).
Conclusion
Increased hand functions and the corticospinal tract excitability were obtained by 2 mA, 20 minute anodal DC polarization. Anodal DC polarization to primary motor cortex may play a potential role for facilitating the corticospinal tract thereby enhancing hand motor recovery in stroke patients. (J Korean Acad Rehab Med 2009; 33: 259-264)

Key Words: Tanscranial direct current stimulation, Motor cortex, Brain polarization, Hand function