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Neurosci Lett. 2014 May 21;569:6-11. doi: 10.1016/j.neulet.2014.03.011. Epub 2014 Mar 13.

Combination of transcranial direct current stimulation and methylphenidate in subacute stroke.

Author information

  • 1Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States.
  • 2Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, China; Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States.
  • 3Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Department of Rehabilitation Medicine, School of Medicine, Ewha Womans University, Republic of Korea.
  • 4Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Charit√© - Universit√§tsmedizin Berlin, Medical Department I Gastroenterology, Infectiology and Rheumatology, Berlin, Germany.
  • 5Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Malaysia.
  • 6Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States. Electronic address: fregni.felipe@mgh.harvard.edu.

Abstract

Noninvasive transcranial direct current stimulation (tDCS) and methylphenidate (MP) are associated with motor recovery after stroke. Based on the potentially complementary mechanisms of these interventions, we examined whether there is an interactive effect between MP and tDCS. In this preliminary study, we randomized subacute stroke subjects to receive tDCS alone, MP alone or combination of tDCS and MP. A blinded rater measured safety, hand function, and cortical excitability before and after treatment. None of the treatments caused any major or severe adverse effects or induced significant differences in cortical excitability. Analysis of variance of gain score, as measured by Purdue pegboard test, showed a significant between-group difference (F(2,6)=12.167, p=0.008). Post hoc analysis showed that the combination treatment effected greater Purdue pegboard gain scores than tDCS alone (p=0.017) or MP alone (p=0.01). Our preliminary data with nine subjects shows an interesting dissociation between motor function improvement and lack of motor corticospinal plasticity changes as indexed by transcranial magnetic stimulation in subacute stroke subjects.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

KEYWORDS:

Cortical excitability; Methylphenidate; TMS; tDCS

PMID:
24631567
[PubMed - indexed for MEDLINE]
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