A meta-analysis of the efficacy of anodal transcranial direct current stimulation for upper limb motor recovery in stroke survivors

Study Design: Systematic review and meta-analysis. Introduction: Prior reviews on the effects of anodal transcranial direct current stimulation (a-tDCS) have shown the effectiveness of a-tDCS on corticomotor excitability and motor function in healthy individuals but nonsignificant effect in subjects with stroke. Purpose: To summarize and evaluate the evidence for the efficacy of a-tDCS in the treatment of upper limb motor impairment after stroke. Methods: A meta-analysis of randomized controlled trials that compared a-tDCS with placebo and change from baseline. Results: A pooled analysis showed a significant increase in scores in favor of a-tDCS (standard mean difference [SMD] = 0.40, 95% confidence interval [CI] = 0.10-0.70, p = 0.010, compared with baseline). A similar effect was observed between a-tDCS and sham (SMD = 0.49, 95% CI = 0.18-0.81, p = 0.005). Conclusion: This meta-analysis of eight randomized placebo-controlled trials provides further evidence that a-tDCS may benefit motor function of the paretic upper limb in patients suffering from chronic stroke. Level of Evidence: Level la. Published by Elsevier Inc. on behalf of Hanley & Belfus, an imprint of Elsevier Inc.