Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke

Bernhard Elsner, Joachim Kugler, Marcus Pohl, Jan Mehrholz, Bernhard Elsner, Joachim Kugler, Marcus Pohl, Jan Mehrholz

Abstract

Background: Stroke is one of the leading causes of disability worldwide. Functional impairment, resulting in poor performance in activities of daily living (ADL) among stroke survivors is common. Current rehabilitation approaches have limited effectiveness in improving ADL performance, function, muscle strength, and cognitive abilities (including spatial neglect) after stroke, with improving cognition being the number one research priority in this field. A possible adjunct to stroke rehabilitation might be non-invasive brain stimulation by transcranial direct current stimulation (tDCS) to modulate cortical excitability, and hence to improve these outcomes in people after stroke.

Objectives: To assess the effects of tDCS on ADL, arm and leg function, muscle strength and cognitive abilities (including spatial neglect), dropouts and adverse events in people after stroke.

Search methods: We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase and seven other databases in January 2019. In an effort to identify further published, unpublished, and ongoing trials, we also searched trials registers and reference lists, handsearched conference proceedings, and contacted authors and equipment manufacturers.

Selection criteria: This is the update of an existing review. In the previous version of this review, we focused on the effects of tDCS on ADL and function. In this update, we broadened our inclusion criteria to compare any kind of active tDCS for improving ADL, function, muscle strength and cognitive abilities (including spatial neglect) versus any kind of placebo or control intervention.

Data collection and analysis: Two review authors independently assessed trial quality and risk of bias, extracted data, and applied GRADE criteria. If necessary, we contacted study authors to ask for additional information. We collected information on dropouts and adverse events from the trial reports.

Main results: We included 67 studies involving a total of 1729 patients after stroke. We also identified 116 ongoing studies. The risk of bias did not differ substantially for different comparisons and outcomes. The majority of participants had ischaemic stroke, with mean age between 43 and 75 years, in the acute, postacute, and chronic phase after stroke, and level of impairment ranged from severe to less severe. Included studies differed in terms of type, location and duration of stimulation, amount of current delivered, electrode size and positioning, as well as type and location of stroke. We found 23 studies with 781 participants examining the effects of tDCS versus sham tDCS (or any other passive intervention) on our primary outcome measure, ADL after stroke. Nineteen studies with 686 participants reported absolute values and showed evidence of effect regarding ADL performance at the end of the intervention period (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.13 to 0.44; random-effects model; moderate-quality evidence). Four studies with 95 participants reported change scores, and showed an effect (SMD 0.48, 95% CI 0.02 to 0.95; moderate-quality evidence). Six studies with 269 participants assessed the effects of tDCS on ADL at the end of follow-up and provided absolute values, and found improved ADL (SMD 0.31, 95% CI 0.01 to 0.62; moderate-quality evidence). One study with 16 participants provided change scores and found no effect (SMD -0.64, 95% CI -1.66 to 0.37; low-quality evidence). However, the results did not persist in a sensitivity analysis that included only trials with proper allocation concealment. Thirty-four trials with a total of 985 participants measured upper extremity function at the end of the intervention period. Twenty-four studies with 792 participants that presented absolute values found no effect in favour of tDCS (SMD 0.17, 95% CI -0.05 to 0.38; moderate-quality evidence). Ten studies with 193 participants that presented change values also found no effect (SMD 0.33, 95% CI -0.12 to 0.79; low-quality evidence). Regarding the effects of tDCS on upper extremity function at the end of follow-up, we identified five studies with a total of 211 participants (absolute values) without an effect (SMD -0.00, 95% CI -0.39 to 0.39; moderate-quality evidence). Three studies with 72 participants presenting change scores found an effect (SMD 1.07; 95% CI 0.04 to 2.11; low-quality evidence). Twelve studies with 258 participants reported outcome data for lower extremity function and 18 studies with 553 participants reported outcome data on muscle strength at the end of the intervention period, but there was no effect (high-quality evidence). Three studies with 156 participants reported outcome data on muscle strength at follow-up, but there was no evidence of an effect (moderate-quality evidence). Two studies with 56 participants found no evidence of effect of tDCS on cognitive abilities (low-quality evidence), but one study with 30 participants found evidence of effect of tDCS for improving spatial neglect (very low-quality evidence). In 47 studies with 1330 participants, the proportions of dropouts and adverse events were comparable between groups (risk ratio (RR) 1.25, 95% CI 0.74 to 2.13; random-effects model; moderate-quality evidence). AUTHORS' CONCLUSIONS: There is evidence of very low to moderate quality on the effectiveness of tDCS versus control (sham intervention or any other intervention) for improving ADL outcomes after stroke. However, the results did not persist in a sensitivity analyses including only trials with proper allocation concealment. Evidence of low to high quality suggests that there is no effect of tDCS on arm function and leg function, muscle strength, and cognitive abilities in people after stroke. Evidence of very low quality suggests that there is an effect on hemispatial neglect. There was moderate-quality evidence that adverse events and numbers of people discontinuing the treatment are not increased. Future studies should particularly engage with patients who may benefit the most from tDCS after stroke, but also should investigate the effects in routine application. Therefore, further large-scale randomised controlled trials with a parallel-group design and sample size estimation for tDCS are needed.

Trial registration: ClinicalTrials.gov NCT00542256 NCT00783913 NCT00853866 NCT00909714 NCT01007136 NCT01014897 NCT01127789 NCT01143649 NCT01169181 NCT01207336 NCT01356654 NCT01500564 NCT01503073 NCT01519843 NCT01544699 NCT01574989 NCT01644929 NCT01726673 NCT01807637 NCT01828398 NCT01883843 NCT01897025 NCT01969097 NCT01983319 NCT02080286 NCT02109796 NCT02156635 NCT02166619 NCT02209922 NCT02210403 NCT02213640 NCT02254616 NCT02292251 NCT02308852 NCT02325427 NCT02389608 NCT02393651 NCT02399540 NCT02401724 NCT02416791 NCT02422173 NCT02455427.

Conflict of interest statement

Two review authors (Jan Mehrholz and Marcus Pohl) were involved in conducting and analysing the largest of the included trials (Hesse 2011). Bernhard Elsner: none known. Joachim Kugler: none known.

Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Figures

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1
Study flow diagram. Please note that the number of full‐texts is not necessarily equal to the number of studies (e.g. the studies Di Lazzaro 2014a and Di Lazzaro 2014b have been presented in a single full‐text. Moreover there often are several full‐texts of a single trial (e.g. as is the case for Hesse 2011 or Nair 2011).
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Funnel plot of comparison: 1 Primary outcome measure: tDCS for improvement of ADL versus any type of placebo or control intervention, outcome: 1.1 ADL at the end of the intervention period, absolute values (BI points).
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5
Funnel plot of comparison: 1 tDCS versus any type of placebo or passive control intervention, outcome: 1.2 Primary outcome measure: ADL until the end of follow‐up.
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Funnel plot of comparison: 1 tDCS versus any type of placebo or passive control intervention, outcome: 1.3 Secondary outcome measure: upper extremity function at the end of the intervention period.
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Funnel plot of comparison: 1 tDCS versus any type of placebo or passive control intervention, outcome: 1.4 Secondary outcome measure: upper extremity function to the end of follow‐up.
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Funnel plot of comparison: 1 tDCS versus any type of placebo or passive control intervention, outcome: 1.5 Secondary outcome measure: lower extremity function at the end of the intervention period.
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Funnel plot of comparison: 1 tDCS versus any type of placebo or passive control intervention, outcome: 1.6 Secondary outcome measure: muscle strength at the end of the intervention period.
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Funnel plot of comparison: 1 tDCS versus any type of placebo or passive control intervention, outcome: 1.7 Secondary outcome measure: muscle strength at the end of follow‐up.
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Funnel plot of comparison: 1 tDCS versus any type of placebo or passive control intervention, outcome: 1.10 Secondary outcome measure: dropouts, adverse events and deaths during the intervention period.
1.1. Analysis
1.1. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 1: Primary outcome measure: ADL at the end of the intervention period
1.2. Analysis
1.2. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 2: Primary outcome measure: ADL until the end of follow‐up
1.3. Analysis
1.3. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 3: Secondary outcome measure: upper extremity function at the end of the intervention period
1.4. Analysis
1.4. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 4: Secondary outcome measure: upper extremity function to the end of follow‐up
1.5. Analysis
1.5. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 5: Secondary outcome measure: lower extremity function at the end of the intervention period
1.6. Analysis
1.6. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 6: Secondary outcome measure: muscle strength at the end of the intervention period
1.7. Analysis
1.7. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 7: Secondary outcome measure: muscle strength at the end of follow‐up
1.8. Analysis
1.8. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 8: Secondary outcome measure: cognitive abilities at the end of the intervention period
1.9. Analysis
1.9. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 9: Secondary outcome measure: hemispatial neglect at the end of intervention period
1.10. Analysis
1.10. Analysis
Comparison 1: tDCS versus any type of placebo or passive control intervention, Outcome 10: Secondary outcome measure: dropouts, adverse events and deaths during the intervention period
2.1. Analysis
2.1. Analysis
Comparison 2: tDCS versus any type of active control intervention, Outcome 1: Primary outcome measure: ADL at the end of the intervention period, absolute values
2.2. Analysis
2.2. Analysis
Comparison 2: tDCS versus any type of active control intervention, Outcome 2: Secondary outcome measure: upper extremity function at the end of the intervention period
2.3. Analysis
2.3. Analysis
Comparison 2: tDCS versus any type of active control intervention, Outcome 3: Secondary outcome measure: upper extremity function to the end of follow‐up
2.4. Analysis
2.4. Analysis
Comparison 2: tDCS versus any type of active control intervention, Outcome 4: Secondary outcome measure: lower extremity function at the end of the intervention period
2.5. Analysis
2.5. Analysis
Comparison 2: tDCS versus any type of active control intervention, Outcome 5: Secondary outcome measure: muscle strength at the end of the intervention period
2.6. Analysis
2.6. Analysis
Comparison 2: tDCS versus any type of active control intervention, Outcome 6: Secondary outcome measure: spatial neglect at the end of the intervention period
2.7. Analysis
2.7. Analysis
Comparison 2: tDCS versus any type of active control intervention, Outcome 7: Secondary outcome measure: dropouts, adverse events and deaths during the intervention period
3.1. Analysis
3.1. Analysis
Comparison 3: Subgroup analyses for primary outcome measure: ADL at the end of the intervention period, Outcome 1: Planned analysis: duration of illness ‐ acute/subacute phase versus postacute phase for ADL at the end of the intervention period
3.2. Analysis
3.2. Analysis
Comparison 3: Subgroup analyses for primary outcome measure: ADL at the end of the intervention period, Outcome 2: Planned analysis: effects of type of stimulation (A‐tDCS/C‐tDCS/dual‐tDCS) and location of stimulation (lesioned/non‐lesioned hemisphere) on ADL at the end of the intervention period (study groups collapsed)
3.3. Analysis
3.3. Analysis
Comparison 3: Subgroup analyses for primary outcome measure: ADL at the end of the intervention period, Outcome 3: Planned analysis: type of control intervention (sham tDCS, conventional therapy or nothing)

References

References to studies included in this review Allman 2016 {published data only}

    1. Allman C, Amadi U, Winkler AM, Wilkins L, Filippini N, Kischka U, et al. Ipsilesional anodal tDCS enhances the functional benefits of rehabilitation in patients after stroke. Science Translational Medicine 2016;(330).
    1. NCT01414582. Transcranial stimulation and motor training in stroke rehabilitation. (accessed 4 March 2013).
Andrade 2017 {published data only}
    1. Andrade SM, Batista LM, Nogueira L, De Oliveira EA, De Carvalho AGC, Lima SS, et al. Constraint-induced movement therapy combined with transcranial direct current stimulation over premotor cortex improves motor function in severe stroke: a pilot randomized controlled trial. Rehabilitation Research and Practice 2017;2017.
    1. Andrade SM, Santos NA, Fernandez-Calvo B, Boggio PS, Oliveira EA, Ferreira JJ, et al. Stroke Treatment Associated with Rehabilitation Therapy and Transcranial DC Stimulation (START-tDCS): a study protocol for a randomized controlled trial. Trials 2016;(1).
    1. NCT02628561. Transcranial direct current stimulation associate to constraint induced movement therapy over premotor cortex in severe stroke. (accessed 9 December 2019).
Ang 2012 {published and unpublished data}
    1. Ang KK, Guan C, Phua KS, Wang C, Teh I, Chen CW, et al. In: Transcranial direct current stimulation and EEG-based motor imagery BCI for upper limb stroke rehabilitation. Proceedings of the 34th Annual International Conference of the IEEE Engineering in Medicine and Biology Society; 2012 Aug 28 - Sept 1; San Diego. 2012. [1557-170X]
    1. Ang KK, Guan C, Phua KS, Wang C, Zhao L, Teo WP, et al. Facilitating effects of transcranial direct current stimulation on motor imagery brain-computer interface with robotic feedback for stroke rehabilitation. Archives of Physical Medicine and Rehabilitation 2015;96(3 Suppl):S79-87. [1532-821X: (Electronic)]
Au‐Yeung 2014 {published data only}
    1. Au-Yeung S, Wang J, Chen Y, Chua E. TDCS to primary motor area improves hand dexterity and selective attention in chronic stroke. Clinical Neurophysiology 2014;125:S142. [1388-2457]
    1. Au-Yeung SSY, Wang J, Ye C, Chua E. Transcranial direct current stimulation to primary motor area improves hand dexterity and selective attention in chronic stroke. American Journal of Physical Medicine & Rehabilitation 2014;95(12):1057-64. [0894-9115]
    1. Park E, Kwon TG, Chang WH, Kim YH. Non-invasive brain stimulation for motor function of chronic stroke patients. In: International Stroke Conference Poster Abstracts. 2014. [0039-2499]
Bang 2015 {published data only}
    1. Bang D-H, Bong S-Y. Effect of combination of transcranial direct current stimulation and feedback training on visuospatial neglect in patients with subacute stroke: a pilot randomized controlled trial. Journal of Physical Therapy Science 2015;27(9):2759-61. [0915-5287]
Boggio 2007a {published data only}
    1. Boggio PS, Nunes A, Rigonatti SP, Nitsche MA, Pascual-Leone A, Fregni F. Repeated sessions of noninvasive brain DC stimulation is associated with motor function improvement in stroke patients. Restorative Neurology and Neuroscience 2007;25(2):123-9.
Bolognini 2011 {published and unpublished data}
    1. Bolognini N, Vallar G, Casati C, Latif LA, El-Nazer R, Williams J, et al. Neurophysiological and behavioral effects of tDCS combined with constraint-induced movement therapy in poststroke patients. Neurorehabilitation and Neural Repair 2011;25(9):819-29.
Cha 2014 {published data only}
    1. Cha HK, Ji SG, Kim MK, Chang JS. Effect of transcranial direct current stimulation of function in patients with stroke. Journal of Physical Therapy Science 2014;26(3):363-5. [0915-5287]
Chang 2015 {published data only}
    1. Chang MC, Kim DY, Park DH. Enhancement of cortical excitability and lower limb motor function in patients with stroke by transcranial direct current stimulation. Brain Stimulation 2015;8(3):561-6. [1935-861X]
Chelette 2014 {published data only}
    1. Chelette K, Carrico C, Nichols L, Sawaki L. Optimizing transcranial direct current stimulation for motor recovery from severe post-stroke hemiparesis: early results from an ongoing clinical trial. Archives of Physical Medicine and Rehabilitation 2012;93(10):E20. [0003-9993]
    1. Chelette K, Sawaki L. Effects of electrode configurations in transcranial direct current stimulation after stroke. In: 16th International Conference on e-Health Networking, Applications and Services (Healthcom). Natal, 2014:12-7.
Cho 2017 {published data only}
    1. Cho JY, Lee A, Kim MS, Park E, Chang WH, Shin YI, et al. Dual-mode noninvasive brain stimulation over the bilateral primary motor cortices in stroke patients. Restorative Neurology and Neuroscience 2017;35(1):105‐14.
Cunningham 2015 {published data only}
    1. Cunningham DA, Varnerin N, Machado A, Bonnett C, Janini D, Roelle S, et al. Stimulation targeting higher motor areas in stroke rehabilitation: a proof-of-concept, randomized, double-blinded placebo-controlled study of effectiveness and underlying mechanisms. Restorative Neurology and Neuroscience 2015;6:911-26.
    1. NCT01539096. Brain stimulation-aided stroke rehabilitation: neural mechanisms of recovery. (accessed 4 March 2013).
    1. Plow EB, Cunningham DA, Beall E, Jones S, Wyant A, Bonnett C, et al. Effectiveness and neural mechanisms associated with tDCS delivered to premotor cortex in stroke rehabilitation: study protocol for a randomized controlled trial. Trials 2013;14(1):331.
D'Agata 2016 {published data only}
    1. D'Agata F, Peila E, Cicerale A, Caglio MM, Caroppo P, Vighetti S, et al. Cognitive and neurophysiological effects of non-invasive brain stimulation in stroke patients after motor rehabilitation. Frontiers in Behavioral Neuroscience 2016;10:135. [1662-5153]
    1. NCT02525393. Transcranial stimulation in motor stroke rehabilitation. 2015.
Danzl 2012 {published data only}
    1. Danzl MM, Chelette K, Lee K, Lykins D, Sawaki L. Non-invasive brain stimulation paired with a novel locomotor training in chronic stroke: a feasibility study. Archives of Physical Medicine and Rehabilitation 2012;93(10):E19-20. [0003-9993]
    1. Danzl MM, Chelette KC, Lee K, Lykins D, Sawaki L. Brain stimulation paired with novel locomotor training with robotic gait orthosis in chronic stroke: a feasibility study. Neurorehabilitation 2013;33(1):67-76.
Di Lazzaro 2014a {published data only}
    1. Di Lazzaro V, Dileone M, Capone F, Pellegrino G, Ranieri F, Musumeci G, et al. Immediate and late modulation of interhemispheric imbalance with bilateral transcranial direct current stimulation in acute stroke. Brain Stimulation 2014;7(6):841-8. [1935-861X]
Di Lazzaro 2014b {published data only}
    1. Di Lazzaro V, Dileone M, Capone F, Pellegrino G, Ranieri F, Musumeci G, et al. Immediate and late modulation of interhemipheric imbalance with bilateral transcranial direct current stimulation in acute stroke. Brain Stimulation 2014;7(6):841-8. [1935-861X]
Fregni 2005a {published data only}
    1. Fregni F, Boggio PS, Mansur CG, Wagner T, Ferreira MJL, Lima MC, et al. Transcranial direct current stimulation of the unaffected hemisphere in stroke patients. Neuroreport 2005;16(14):1551-5.
Fusco 2013a {published and unpublished data}
    1. Fusco A, De Angelis D, Morone G, Maglione L, Paolucci T, Bragoni M, et al. The ABC of tDCS: effects of anodal, bilateral and cathodal montages of transcranial direct current stimulation in patients with stroke - a pilot study. Stroke Research and Treatment 2013 Jan 8 [Epub ahead of print]. [2090-8105]
Fusco 2014 {published data only}
    1. Fusco A, Assenza F, Iosa M, Izzo S, Altavilla R, Paolucci S, et al. The ineffective role of cathodal tDCS in enhancing the functional motor outcomes in early phase of stroke rehabilitation: an experimental trial. BioMed Research International 2014 May 5 [Epub ahead of print]. [2314-6133]
    1. Fusco A, Iosa M, Venturiero V, De Angelis D, Morone G, Maglione L, et al. After vs. priming effects of anodal transcranial direct current stimulation on upper extremity motor recovery in patients with subacute stroke. Restorative Neurology and Neuroscience 2014;32(2):301-12. [0922-6028]
Geroin 2011 {published and unpublished data}
    1. Geroin C, Picelli A, Munari D, Waldner A, Tomelleri C, Smania N. Combined transcranial direct current stimulation and robot-assisted gait training in patients with chronic stroke: a preliminary comparison. Clinical Rehabilitation 2011;25(6):537-48.
    1. NCT01040299. Mechanized gait trainer combine transcranial galvanic stimulation (tDCS) in chronic stroke. (accessed 4 March 2013).
Hamoudi 2018 {published data only}
    1. Hamoudi M, Schambra HM, Fritsch B, Schoechlin-Marx A, Weiller C, Cohen LG, et al. Transcranial direct current stimulation enhances motor skill learning but not generalization in chronic stroke. Neurorehabilitation and Neural Repair 2018;32(4‐5):295‐308.
    1. NCT00314769. Long-term improvement in motor learning by transcranial direct current stimulation. (accessed 19 September 2019).
Hathaiareerug 2019 {published data only}
    1. Hathaiareerug C, Vearasilp A. Comparison between transcranial direct current stimulation and acupuncture on upper extremity rehabilitation in stroke: a single-blind randomized controlled trial. Journal of the Medical Association of Thailand 2019;102(8):874-9.
    1. TCTR20150629002. TDCS versus electroacupuncture in upper extremity function among stroke. (accessed 9 December 2019).
Hesse 2011 {published data only}
    1. Hesse S, Waldner A, Mehrholz J, Tomelleri C, Pohl M, Werner C. Combined transcranial direct current stimulation and robot-assisted arm training in subacute stroke patients: an exploratory, randomized multicenter trial. [German]. Neurologie und Rehabilitation 2012;18(4):242-7. [0947-2177]
    1. Hesse S, Waldner A, Mehrholz J, Tomelleri C, Pohl M, Werner C. Combined transcranial direct current stimulation and robot-assisted arm training in subacute stroke patients: an exploratory, randomized multicenter trial. Neurorehabilitation and Neural Repair 2011;25(9):838-46.
    1. NCT00407667. Transcranial galvanic stimulation after stroke. (accessed 4 March 2013).
    1. Waldner A, Werner C, Mehrholz J, Tomelleri C, Pohl M, Hesse S. Combined transcranial direct current stimulation and robot-assisted arm training in subacute stroke patients. Neurorehabilitation and Neural Repair 2012;26(4):400 (Abst 009).
    1. Werner C, Hesse S, Kroczek G, Waldner A. Transcranial galvanic stimulation (tDCS) + robot-assisted therapy to improve upper limb impairment after stroke: a double-blind placebo controlled trial: preliminary results. Neurorehabilitation and Neural Repair 2008;22(5):550-1.
    1. Werner C, Hesse S. Transcranial direct current stimulation (tDCS) and repetitive arm training to enhance motor function of the severely affected arm after stroke: a double blind placebo RCT (TRAGAT) - preliminary results. Cerebrovascular Diseases 2009;27 Suppl 6:147.
Ilić 2016 {published data only}
    1. Ilić NV, Dubljanin-Raspopović E, Nedeljković U, Tomanović-Vujadinović S, Milanović SD, Petronić-Marković I, et al. Effects of anodal tDCS and occupational therapy on fine motor skill deficits in patients with chronic stroke. Restorative Neurology and Neuroscience 2016;34(6):935‐45.
    1. NCT02542982. tDCS and motor training and motor deficit after stroke. 2015.
Jo 2008a {published data only}
    1. Jo JM, Kim YH, Ko MH, Ohn SH, Joen B, Lee KH. Enhancing the working memory of stroke patients using tDCS. American Journal of Physical Medicine & Rehabilitation 2009;88(5):404-9.
    1. Jo JM, Ohn SH, Ko MH, Kim GM, Yoo WK, Woo PK, et al. Effects of transcranial direct current stimulation on verbal working memory in patients with stroke. Journal of Rehabilitation Medicine 2008;40(Suppl 46):146.
Kang 2008b {published and unpublished data}
    1. Kang EK, Baek MJ, Kim S, Paik NJ. Non-invasive cortical stimulation improves post-stroke attention decline. Restorative Neurology and Neuroscience 2009;27(6):645-50.
    1. Kang EK, Lim JY, Baek MJ, Kim SY, Paik NJ. The effect of anodal transcranial direct current stimulation on post-stroke attention decline. International Journal of Stroke 2008;3 Suppl 1:351.
Khedr 2013 {published data only}
    1. Khedr E, Shawky O, Tohamy A, Darwish E, El Hamady D. Effect of anodal versus cathodal transcranial direct current stimulation on stroke recovery: a pilot randomized controlled trial. European Journal of Neurology 2012;19:185. [1351-5101]
    1. Khedr EM, Shawky OA, El-Hammady DH, Rothwell JC, Darwish ES, Mostafa OM, et al. Effect of anodal versus cathodal transcranial direct current stimulation on stroke rehabilitation: a pilot randomized controlled trial. Neurorehabilitation and Neural Repair 2013 Apr 22 [Epub ahead of print]. [DOI: 10.1177/1545968313484808]
    1. NCT01601392. Anodal and cathodal transcranial direct current stimulation in stroke recovery. (accessed 4 March 2013).
Kim 2009 {published and unpublished data}
    1. Kim DY, Ohn SH, Yang EJ, Park C-I, Jung KJ. Enhancing motor performance by anodal transcranial direct current stimulation in subacute stroke patients. American Journal of Physical Medicine & Rehabilitation 2009;88(10):829-36.
    1. Kim DY, Park CI, Ohn SH, Yang EJ. Effects of transcranial direct current stimulation on motor performance in subacute poststroke patients. Neurorehabilitation and Neural Repair 2006;20(1):166.
Kim 2010 {published data only}
    1. Kim DY, Lim JY, Kang EK, You DS, Oh MK, Oh BM, et al. Effect of transcranial direct current stimulation on motor recovery in patients with subacute stroke. American Journal of Physical Medicine & Rehabilitation 2010;89(11):879-86.
Kim 2016 {published data only}
    1. Kim K-U, Kim S-H, An T-G. Effect of transcranial direct current stimulation on visual perception function and performance capability of activities of daily living in stroke patients. Journal of Physical Therapy Science 2016;28(9):2572-5. [0915-5287]
    1. Kim YH, Cho JY, Lee AH, Park CH, Kim MS, Chang WH. Dual-mode-noninvasive brain stimulation over the primary motor cortices in stroke patients. International journal of stroke 2015;10 Suppl 2:90.
Klomjai 2018 {published data only}
    1. Klomjai W, Aneksan B, Pheungphrarattanatrai A, Chantanachai T, Choowong N, Bunleukhet S, et al. Effect of single-session dual-tDCS before physical therapy on lower-limb performance in sub-acute stroke patients: a randomized sham-controlled crossover study. Annals of Physical and Rehabilitation \medicine 2018;61(5):286‐91.
    1. NCT03035162. Dual-hemisphere transcranial direct current stimulation on lower limb motor functions after stroke. (accessed 9 December 2019).
Ko 2008a {published data only}
    1. Ko MH, Han SH, Park SH, Seo JH, Kim YH. Improvement of visual scanning after DC brain polarization of parietal cortex in stroke patients with spatial neglect. Neuroscience Letters 2008;448(2):171-4. [0304-3940]
Koo 2018 {published data only}
    1. KCT0002496. Effects of anodal transcranial direct current stimulation on somatosensory recovery after stroke. (accessed 26 September 2019).
    1. Koo Woo R, Jang Baek H, Kim Chung R. Effects of anodal transcranial direct current stimulation on somatosensory recovery after stroke: a randomized controlled trial. American Journal of Physical Medicine & Rehabilitation 2018;97(7):507‐13.
Lee 2014 {published data only}
    1. Lee SJ, Chun MH. Combination transcranial direct current stimulation and virtual reality therapy for upper extremity training in patients with subacute stroke. Archives of Physical Medicine & Rehabilitation 2014;95(3):431-8. [0003-9993]
Lindenberg 2010 {published data only}
    1. Lindenberg R, Nair D, Zhu LL, Renga V, Schlaug G. Non-invasive motor cortex stimulation after stroke: the effect of number of sessions on outcome. Stroke 2011;42(3):e72.
    1. Lindenberg R, Renga V, Zhu LL, Nair D, Schlaug G. Bihemispheric brain stimulation facilitates motor recovery in chronic stroke patients. Neurology 2010;75(24):2176-84.
    1. Lindenberg R, Zhu LL, Schlaug G. Combined central and peripheral stimulation to facilitate motor recovery after stroke: the effect of number of sessions on outcome. Neurorehabilitation and Neural Repair 2012;26(5):479-83.
    1. NCT00792428. Non-invasive brain stimulation and occupational therapy to enhance stroke recovery. (accessed 9 December 2019).
Mahmoudi 2011 {published data only}
    1. Mahmoudi H, Borhani HA, Petramfar P, Jahanshahi S, Salehi Z, Fregni F. Transcranial direct current stimulation: electrode montage in stroke. Disability and Rehabilitation 2011;33(15-16):1383-8.
Manji 2018 {published data only}
    1. Manji A, Amimoto K, Matsuda T, Wada Y, Inaba A, Ko S. Effects of transcranial direct current stimulation over the supplementary motor area body weight-supported treadmill gait training in hemiparetic patients after stroke. Neuroscience Letters 2018;662:302‐5.
Mazzoleni 2019 {published data only}
    1. Mazzoleni S, Tran V, Dario P, Posteraro F. Effects of transcranial direct current stimulation (tDCS) combined with wrist robot-assisted rehabilitation on motor recovery in subacute stroke patients: a randomized controlled trial. IEEE Transactions on Neural Systems and Rehabilitation Engineering 2019;27(7):1458-66.
    1. NCT02496026. Transcranial direct current stimulation and robotic therapy in upper limb motor recovery after stroke. (accessed 9 December 2019).
Mortensen 2016 {published data only}
    1. Mortensen J, Figlewski K, Andersen H. Combined transcranial direct current stimulation and home-based occupational therapy for upper limb motor impairment following intracerebral hemorrhage: a double-blind randomized controlled trial. Disability and Rehabilitation 2016;38(7):637-43. [0963-8288]
    1. NCT01992991. Transcranial stimulation for upper limb training of individuals with sequelae from intracranial hemorrhage. (accessed 9 December 2019).
Nair 2011 {published data only (unpublished sought but not used)}
    1. Nair D, Renga V, Hamelin S, Pascual-Leone A, Schlaug G. Improving motor function in chronic stroke patients using simultaneous occupational therapy and TDCS. Stroke 2008;39(2):542.
    1. Nair DG, Hamelin S, Pascual-Leone A, Schlaug G, Israel B. Transcranial direct current stimulation in combination with occupational therapy for 5 consecutive days improves motor function in chronic stroke patients. Stroke 2007;38(2):518.
    1. Nair DG, Renga V, Lindenberg R, Zhu L, Schlaug G. Optimizing recovery potential through simultaneous occupational therapy and non-invasive brain-stimulation using tDCS. Restorative Neurology and Neuroscience 2011;29(6):411-20.
    1. NCT00792428. Non-invasive brain stimulation and occupational therapy to enhance stroke recovery. (accessed 4 March 2013).
    1. Renga V, Lindenberg R, Zhu L, Nair D, Schlaug G. Facilitating stroke recovery using simultaneous occupational therapy and bi-hemispheric brain-stimulation. Stroke 2009;40(4):e150.
    1. Schlaug G, Betzler F, Zhu L, Lindenberg R. Plastic changes in corticospinal motor tracts are related to motor improvement in chronic stroke patients. Stroke 2010;41(4):e210. [0039-2499]
    1. Schlaug G. TDCS+OT. Non-invasive brain stimulation and occupational therapy to enhance stroke recovery. Stroke Trials Registry, Internet Stroke Center: 2006. [CENTRAL: CN-00709259]
Nicolo 2017 {published data only}
    1. NCT02031107. Randomized trial of transcranial theta-burst stimulation and transcranial direct current stimulation. (accessed 7 September 2015).
    1. Nicolo P, Magnin C, Pedrazzini E, Nguyen-Danse A, Guggisberg AG. Transcranial direct current stimulation reduces secondary white-matter degradation after stroke. Brain Stimulation 2018;11(6):1417-9. [1935-861X]
    1. Nicolo P, Magnin C, Pedrazzini E, Plomp G, Mottaz A, Schnider A, et al. Comparison of neuroplastic responses to cathodal transcranial direct current stimulation and continuous theta burst stimulation in subacute stroke. Archives of Physical Medicine and Rehabilitation 2018;99(5):862-72.
    1. Nicolo P, Pedrazzini E, Schnider A, Guggisberg A. Transcranial direct current stimulation boosts spontaneous motor plasticity in subacute stroke. European Journal of Neurology 2017;24:99‐100.
Park 2013 {published data only}
    1. Kim HM, Lee SI, Chun MH. The effects of direct current brain polarization on motor recovery of lower extremity in stroke. Archives of Physical Medicine and Rehabilitation 2011;(10):1715.
    1. Park DH. The effects of direct current brain polarization on motor recovery of lower extremity in stroke. Archives of Physical Medicine and Rehabilitation 2013;9 Suppl 1:S241-S242.
    1. Park SH, Koh EJ, Choi HY, Ko MH. A double-blind, sham-controlled, pilot study to assess the effects of the concomitant use of transcranial direct current stimulation with the computer assisted cognitive rehabilitation to the prefrontal cortex on cognitive functions in patients with stroke. Journal of Korean Neurosurgical Society 2013;56(6):484-8.
Park 2015 {published data only}
    1. Park SD, Kim JY, Song HS. Effect of application of transcranial direct current stimulation during task-related training on gait ability of patients with stroke. Journal of Physical Therapy Science 2015;27(3):623-5. [0915-5287]
Picelli 2015 {published data only}
    1. Picelli A, Chemello E, Castellazzi P, Roncari L, Waldner A, Saltuari L, et al. Combined effects of transcranial direct current stimulation (tDCS) and transcutaneous spinal direct current stimulation (tsDCS) on robot-assisted gait training in patients with chronic stroke: A pilot, double blind, randomized controlled trial. Restorative Neurology and Neuroscience 2015;33(3):357-68. [0922-6028]
Qu 2009 {published data only (unpublished sought but not used)}
    1. Qu YP, Wu DY, Tu XQ, Qian L, Yang YB, Geng H. Effect of transcranial direct current stimulation on relieving upper-limb spasticity after stroke [Chinese]. Chinese Journal of Cerebrovascular Diseases 2009;6(11):586-9.
Qu 2017 {published data only}
    1. Qu S, Song, W. Effect of cathodal transcranial direct current stimulation on upper limb motor function in patients with stroke. Chinese Journal of Cerebrovascular Diseases 2017;14(12):622-7.
Rabadi 2017 {published data only}
    1. NCT01201629. Transcranial direct current stimulation (tDCS). (accessed 4 March 2013).
    1. Rabadi MH, Aston CE. Effect of transcranial direct current stimulation on severely affected arm-hand motor function in patients after an acute ischemic stroke: a pilot randomized control trial. American Journal of Physical Medicine & Rehabilitation 2017;96(10 Suppl 1):S178‐S184.
Rocha 2016 {published data only}
    1. NCT01879787. Effects of tDCS combined with mCIMT or mental practice in poststroke patients. (accessed 7 September 2015).
    1. Rocha S, Silva E, Foerster A, Wiesiolek C, Chagas AP, Machado G, et al. The impact of transcranial direct current stimulation (tDCS) combined with modified constraint-induced movement therapy (mCIMT) on upper limb function in chronic stroke: a double-blind randomized controlled trial. Disability and Rehabilitation 2016;38(7):653-60. [0963-8288]
Rossi 2013 {published and unpublished data}
    1. Rossi C, Sallustio F, Di Legge S, Rizzato B, Stanzione P, Koch G. Anodal transcranial direct current stimulation (TDCS) of the affected hemisphere in patients with acute ischemic stroke: a preliminary study. Cerebrovascular Diseases 2010;34:247-8. [1015-9770]
    1. Rossi C, Sallustio F, Di Legge S, Stanzione P, Koch G. Transcranial direct current stimulation of the affected hemisphere does not accelerate recovery of acute stroke patients. European Journal of Neurology 2013;20(1):202-4.
Saeys 2015 {published data only}
    1. Saeys W, Vereeck L, Lafosse C, Truijen S, Wuyts FL, Van De Heyning P. Transcranial direct current stimulation in the recovery of postural control after stroke: a pilot study. Disability and Rehabilitation 2015;37(20):1857-63.
Salazar 2019 {published data only}
    1. NCT02818608. Transcranial direct current stimulation and functional electrical stimulation for rehabilitation after stroke. (accessed 9 December 2019).
    1. Salazar AP, Cimolin V, Schifino GP, Rech KD, Marchese RR, Pagnussat AS. Bi-cephalic transcranial direct current stimulation combined with functional electrical stimulation for upper-limb stroke rehabilitation: A double-blind randomized controlled trial. Annals of Physical & Rehabilitation Medicine 2019;63(1):4-11. [1877-0665: (Electronic)]
Sattler 2015 {published data only}
    1. Sattler V, Acket B, Raposo N, Albucher J-F, Thalamas C, Loubinoux I, et al. Anodal tDCS Ccmbined with radial nerve stimulation promotes hand motor recovery in the acute phase after ischemic stroke. Neurorehabilitation & Neural Repair 2015;29(8):743-54. [1552-6844]
Seo 2017 {published data only}
    1. NCT01945515. Robotic-assisted gait training combined with transcranial direct current stimulation to maximize gait recovery after stroke. (accessed 7 September 2015).
    1. Seo HG, Lee WH, Lee SH, Yi Y, Kim KD, Lee HH, et al. Robotic-assisted gait training combined with transcranial direct current stimulation in chronic stroke patients. Archives of Physical Medicine and Rehabilitation 2017;98(10):e106‐e107.
    1. Seo HG, Lee WH, Lee SH, Yi Y, Kim KD, Oh BM. Robotic-assisted gait training combined with transcranial direct current stimulation in chronic stroke patients: a pilot double-blind, randomized controlled trial. Restorative Neurology and Neuroscience 2017;35(5):527‐36.
Shaheiwola 2018 {published data only}
    1. Shaheiwola N, Zhang B, Jai J, Zhang D. Using tDCS as an add-on treatment prior to FES therapy in improving upper limb function in severe chronic stroke patients: a randomized controlled study. Frontiers in Human Neuorscience 2018;12:233.
Sik 2015 {published data only}
    1. Sik BY, Dursun N, Dursun E, Sade I, SahIn E. Transcranial direct current stimulation: The effects on plegic upper extremity motor function of patients with stroke. Journal of Neurological Sciences 2015;32(2):320-34. [1300-1817]
Sohn 2013 {published data only}
    1. Sohn M, Jee S, Kim W. Effect of transcranial direct current stimulation on postural stability and lower extremity strength in hemiplegic stroke patients. Annals of Rehabilitation Medicine 2013;37(6):759-65. [2234-0645]
Straudi 2016 {published data only}
    1. Straudi S, Fregni F, Martinuzzi C, Pavarelli C, Salvioli S, Basaglia N. tDCS and robotics on upper limb stroke rehabilitation: effect modification by stroke duration and type of stroke. BioMed Research International 2016;2016 (no pagination)(5068127). [2314-6133]
Sunwoo 2013a {published data only}
    1. Sunwoo H, Kim YH, Chang WH, Noh S, Kim EJ, Ko MH. Effects of dual transcranial direct current stimulation on post-stroke unilateral visuospatial neglect. Neuroscience Letters 2013;554:94-8.
Tahtis 2012 {published data only}
    1. Kaski DM, Tahtis VM, Seemungal BM. The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in subacute stroke. Journal of Neurology 2014;261:S165. [0340-5354]
    1. Tahtis V, Kaski D, Seemungal BM. The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in sub-acute stroke: a pilot study. Restorative Neurology and Neuroscience 2014;32(4):527-32. [0922-6028]
    1. Tahtis V, Kaski D, Seemungal BM. The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in sub-acute stroke. Cerebrovascular Diseases 2012;33 Suppl 2:42.
Tedesco Triccas 2015b {published and unpublished data}
    1. NCT01405378. Non-invasive brain stimulation for people with stroke. (accessed 4 March 2013).
    1. Tedesco Triccas L, Burridge J, Hughes AM, Verheyden G, Desikan M, Rothwell J, et al. Combining non-invasive brain stimulation with unilateral and three-dimensional robot therapy for the impaired upper limb in stroke rehabilitation. Cerebrovascular Diseases 2014;37 Suppl 1:59.
    1. Triccas TL, Burridge J, Hughes AM, Verheyden G, Rothwell J. Combining transcranial direct current stimulation with robot therapy for the impaired upper limb after sub-acute stroke. Clinical Neurophysiology 2011;122:S149-50.
    1. Triccas TL, Burridge JH, Hughes A, Verheyden G, Desikan M, Rothwell J. A double-blinded randomised controlled trial exploring the effect of anodal transcranial direct current stimulation and uni-lateral robot therapy for the impaired upper limb in sub-acute and chronic stroke. Neurorehabilitation 2015;37(2):181-91.
Utarapichat 2018 {published data only}
    1. Utarapichat S, Kitisomprayoonkul W. Effects of transcranial direct current stimulation on motor activity of lower limb muscles in chronic stroke. Journal of the Medical Association of Thailand 2018;101(1):131‐6.
Viana 2014 {published data only}
    1. Viana RT, Laurentino GEC, Souza RJP, Fonseca JB, Silva Filho EM, Dias SN, et al. Effects of the addition of transcranial direct current stimulation to virtual reality therapy after stroke: A pilot randomized controlled trial. Neurorehabilitation 2014;34(3):437-46. [1053-8135]
Wang 2014 {published data only}
    1. Wang QM, Cui H, Han SJ, Black-Schaffer R, Volz MS, Lee YT, et al. Combination of transcranial direct current stimulation and methylphenidate in subacute stroke. Neuroscience Letters 2014;569:6-11. [0304-3940]
Wong 2015 {published data only}
    1. Wong KH, Ho LOL, Chan MMF, Yiu KTH, Poon PYH, To RWK, et al. Effects of combined transcranial direct current stimulation and physiotherapy for upper limb rehabilitation in patients with stroke: A controlled clinical trial...Hong Kong Physiotherapy Association Conference, 3-4 October 2015, Hong Kong. Hong Kong Physiotherapy Journal 2015;33(2):101. [1013-7025]
Wu 2013a {published and unpublished data}
    1. ChiCTR-TRC-11001367. Effects on relieving upper-limb spasticity after stroke using transcranial direct current stimulation. (accessed 4 March 2013).
    1. Wu D, Qian L, Zorowitz R, Zhang L, Qu Y, Yuan Y. Effects on decreasing upper-limb poststroke muscle tone using transcranial direct current stimulation: a randomized sham-controlled study. Archives of Physical Medicine and Rehabilitation 2013;94:1-8.
Yi 2016 {published data only}
    1. Yi YG, Chun MH, Do KH, Sung EJ, Kwon YG, Kim DY. The effect of transcranial direct current stimulation on neglect syndrome in stroke patients. Annals of Rehabilitation Medicine 2016;40(2):223-9. [2234-0645]
Yun 2015 {published data only}
    1. Yun GJ, Chun MH, Kim BR. The effects of transcranial direct-current stimulation on cognition in stroke patients. Journal of Stroke 2015;17(3):354-8. [2287-6391]
References to studies excluded from this review Alves 2017 {published data only}
    1. Alves Fruhauf AM, Politti F, Dal Corso S, Carneiro Costa G, Da ConceiÇÃO TeodÓSio A, Silva SM, et al. Immediate effect of transcranial direct current stimulation combined with functional electrical stimulation on activity of the tibialis anterior muscle and balance of individuals with hemiparesis stemming from a stroke. Journal of Physical Therapy Science 2017;29(12):2138-46. [0915-5287]
Asseldonk 2016 {published data only}
    1. Asseldonk EHF, Boonstra TA. Transcranial direct current stimulation of the leg motor cortex enhances coordinated motor output during walking with a large inter-individual variability. Brain Stimulation 2016;9(2):182-90.
Boggio 2007b {published data only}
    1. Boggio PS, Nunes A, Rigonatti SP, Nitsche MA, Pascual-Leone A, Fregni F. Repeated sessions of noninvasive brain DC stimulation is associated with motor function improvement in stroke patients. Restorative Neurology and Neuroscience 2007;25(2):123-9.
Bradnam 2012 {published data only}
    1. Bradnam LV, Stinear CM, Barber PA, Byblow WD. Contralesional hemisphere control of the proximal paretic upper limb following stroke. Cerebral Cortex 2012;22(11):2662-71. [1460-2199]
Byblow 2011 {published data only}
    1. Byblow W, Bradnam L, Barber PA, Stinear C. Ipsilateral effects of direct current stimulation. In: Proceedings of the 14th European Congress of Clinical Neurophysiology and the 4th International Conference on Transcranial Magnetic and Direct Current Stimulation, Rome, Italy. 2011.
Celnik 2009 {published data only}
    1. Celnik P, Paik N-J, Vandermeeren Y, Dimyan M, Cohen LG. Effects of combined peripheral nerve stimulation and brain polarization on performance of a motor sequence task after chronic stroke. Stroke 2009;40(5):1764-71.
    1. Paik N, Celnik P, Cohen L. Effects of combined peripheral nerve stimulation and noninvasive anodal cortical stimulation on motor learning in chronic stroke. Archives of Physical Medicine and Rehabilitation 2006;87:E2.
Cho 2015 {published data only}
    1. Cho HS, Cha HG. Effect of mirror therapy with tDCS on functional recovery of the upper extremity of stroke patients. Journal of Physical Therapy Science 2015;27(4):1045-7. [0915-5287]
CTRI/2018/04/013380 2018 {published data only}
    1. CTRI/2018/04/013380. A study to assess the role of a minimal current applied over a specific area in head on muscle activity of weaker leg in patients with stroke. (accessed 9 December 2019).
Del Felice 2016 {published data only}
    1. Del Felice A, Daloli V, Masiero S, Manganotti P. Contralesional cathodal tDCS versus dual-tDCS for decreasing upper limb spasticity in chronic stroke individuals: a clinical and neurophysiological study. Clinical Neurophysiology 2016;127(9):e241‐e242.
Edwards 2009 {published data only}
    1. Edwards DJ, Krebs HI, Rykman A, Zipse J, Thickbroom GW, Mastaglia FL, et al. Raised corticomotor excitability of M1 forearm area following anodal tDCS is sustained during robotic wrist therapy in chronic stroke. Restorative Neurology and Neuroscience 2009;27(3):199-207.
Fujimoto 2015 {published data only}
    1. Fujimoto S, Kon N, Otaka Y, Yamaguchi T, Nakayama T, Kondo K, et al. Transcranial direct current stimulation over the primary and secondary somatosensory cortices transiently improves tactile spatial discrimination in stroke patients. Frontiers in Neuroscience 2016;10:128. [1662-4548]
    1. Fujimoto S, Kon N, Otaka Y, Yamaguchi T, Osu R, Kondo K, et al. Transcranial direct current stimulation improves tactile discrimination in stroke patients. Physiotherapy 2015;101:eS428-9. [0031-9406]
Gandiga 2006 {published data only}
    1. Gandiga PC, Hummel FC, Cohen LG. Transcranial DC stimulation (tDCS): a tool for double-blind sham-controlled clinical studies in brain stimulation. Clinical Neurophysiology 2006;117:845-50.
Giacobbe 2013 {published data only}
    1. Giacobbe V, Krebs H, Volpe B, Pascual-Leone A, Rykman A, Zeiarati G, et al. Transcranial direct current stimulation (tDCS) and robotic practice in chronic stroke: the dimension of timing. Neurorehabilitation 2013;33(1):49-56. [1053: 8135]
Goh 2015 {published data only}
    1. Goh HT, Chan HY, Abdul-Latif L. After effects of 2 noninvasive brain stimulation techniques on corticospinal excitability in persons with chronic stroke: a pilot study. Journal of Neurologic Physical Therapy 2015;39(1):15-22. [1557-0576]
Goodwill 2015 {published data only}
    1. Goodwill AM, Teo WP, Daly RM, Morgan P, Kidgell DJ. Effects of bilateral-tDCS combined with upper limb rehabilitation on motor function and cortical plasticity in chronic stroke patients. International Journal of Stroke 2015;10(Suppl 3):49.
Gurchin 1988 {published data only}
    1. Gurchin FA, Medvedev SV, Puzenko VI. Cortical electrostimulation in skull and brain injury [Russian]. Fiziologiia Cheloveka 1988;14(2):324-6.
Hummel 2005a {published data only}
    1. Hummel F, Celnik P, Giraux P, Flöel A, Wu W-H, Gerloff C, et al. Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain 2005;128(Pt 3):490-9.
    1. Hummel F, Wu CJ, Flöel A, Gerloff C, Cohen L. Effects of cortical stimulation on motor function in patients with chronic stroke. Neurology 2004;62 Suppl 5:A459-60 (Abst P06.008).
Hummel 2005b {published data only}
    1. Hummel F, Voller B, Celnik P, Flöel A, Giraux P, Gerloff C, et al. Effects of brain polarization on reaction times and pinch force in chronic stroke. BMC Neuroscience 2006;7:73.
    1. Hummel F, Voller B, Celnik P, Flöel A, Giraux P, Gerloff C, et al. Effects of cortical stimulation on visuomotor integration and force in stroke. Cerebrovascular Diseases 2006;21:4-5 (Abst 9).
Jayaram 2009 {published data only}
    1. Jayaram G, Stinear JW. The effects of transcranial stimulation on paretic lower limb motor excitability during walking. Journal of Clinical Neurophysiology 2009;26(4):272-9.
Kasashima 2012 {published data only}
    1. Kasashima Y, Fujiwara T, Matsushika Y, Tsuji T, Hase K, Ushiyama J, et al. Modulation of event-related desynchronization during motor imagery with transcranial direct current stimulation (tDCS) in patients with chronic hemiparetic stroke. Experimental Brain Research 2012;221(3):263-8.
Kharchenko 2001 {published data only}
    1. Kharchenko EV. Transcranial microelectrostimulation activates fast mechanisms of brain plasticity. Doklady Biological Sciences 2001;378:217-9.
Kim 2014 {published data only}
    1. Kim YJ, Ku J, Cho S, Kim HJ, Cho YK, Lim T, et al. Facilitation of corticospinal excitability by virtual reality exercise following anodal transcranial direct current stimulation in healthy volunteers and subacute stroke subjects. Journal of Neuroengineering and Rehabilitation 2014;11:124.
Kitisomprayoonkul 2012 {published data only}
    1. Kitisomprayoonkul W. Transcranial direct current stimulation improves hand sensation in acute stroke. Archives of Physical Medicine and Rehabilitation 2012;93(10):E33.
Koh 2017 {published data only}
    1. Koh CL, Lin JH, Jeng JS, Huang SL, Hsieh CL. Effects of transcranial direct current stimulation with sensory modulation on stroke motor rehabilitation: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2017;98(12):2477‐84.
Krewer 2013 {published data only}
    1. Krewer C, Riess K, Bergmann J, Muller F, Jahn K, Koenig E. Immediate effectiveness of single-session therapeutic interventions in pusher behaviour. Gait and Posture 2013;37:246-50.
Kumar 2011 {published data only}
    1. Kumar S, Wagner CW, Frayne C, Zhu L, Selim M, Feng W, et al. Noninvasive brain stimulation may improve stroke-related dysphagia: a pilot study. Stroke 2011;42(4):1035-40.
Kwon 2012 {published data only}
    1. Kwon YH, Jang SH. Onsite-effects of dual-hemisphere versus conventional single-hemisphere transcranial direct current stimulation: a functional MRI study. Neural Regeneration Research 2012;7(24):1889-94.
Kwon 2016 {published data only}
    1. Kwon TG, Park E, Kang C, Chang WH, Kim YH. The effects of combined repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function in patients with stroke. Restorative Neurology and Neuroscience 2016;34(6):915‐23.
Lee 2012 {published data only}
    1. Lee YS, Yang HS, Jeong CJ, Yoo YD, Jeong SH, Jeon OK, et al. The effects of transcranial direct current stimulation on functional movement performance and balance of the lower extremities. Journal of Physical Therapy Science 2012;24(12):1215-8. [0915-5287]
Lee 2015 {published data only}
    1. Lee DG, Lee DY. Effects of adjustment of transcranial direct current stimulation on motor function of the upper extremity in stroke patients. Journal of Physical Therapy Science 2015;27(11):3511-3. [0915-5287]
    1. Lee J, Park E, Lee A, Chang WH, Kim DS, Kim YH. Functional network reorganization by dual-mode noninvasive brain stimulation in stroke patients. Brain Stimulation 2017;10(2):439-40. [1876-4754]
    1. Lee J, Park E, Lee A, Chang WH, Kim DS, Shin YI, et al. Modulating brain connectivity by simultaneous dual-mode stimulation over bilateral primary motor cortices in subacute stroke patients. Neural Plasticity 2018;2018:. [2090-5904]
Lee 2018 {published data only}
    1. Lee J, Lee A, Kim H, Shin M, Yun SM, Jung Y, et al. Different brain connectivity between responders and nonresponders to dual-mode noninvasive brain stimulation over bilateral primary motor cortices in stroke patients. Neural Plasticity 2019;2019:3826495. [1687-5443]
    1. Lee J, Park E, Lee A, Chang WH, Kim DS, Shin YI, et al. Modulating brain connectivity by simultaneous dual-mode stimulation over bilateral primary motor cortices in subacute stroke patients. Neural Plasticity 2018;2018:. [2090-5904]
    1. NCT03279640. Effects of brain network by simultaneous dual-mode stimulation in subacute stroke patients. (accessed 9 December 2019).
Lefebvre 2013 {published data only}
    1. Lefebvre S, Laloux P, Peeters A, Desfontaines P, Jamart J, Vandermeeren Y. Dual-tDCS enhances online motor skill learning and long-term retention in chronic stroke patients. Frontiers in Human Neuroscience 2013;6:343.
    1. Lefebvre S, Thonnard JL, Laloux P, Peeters A, Jamart J, Vandermeeren Y. Single session of dual-tDCS transiently improves precision grip and dexterity of the paretic hand after stroke. Neurorehabilitation and Neural Repair 2014;28(2):100-10.
    1. Vandermeeren Y, Laloux P, Jamart J, Peeters A, Thonnard J-L, Lefebvre S. Dual hemisphere tDCS in chronic stroke patients improves 'simple' precision grip and digital dexterity of the paretic hand with a delayed time-course. Cerebrovascular Diseases 2012;33 Suppl 2:63 (Abst 9).
Lefebvre 2015 {published data only}
    1. Lefebvre S, Dricot L, Laloux P, Gradkowski W, Desfontaines P, Evrard F, et al. Neural substrates underlying stimulation-enhanced motor skill learning after stroke. Brain 2015;138:149-63. [0006-8950]
Leon 2017 {published data only}
    1. Leon D, Cortes M, Elder J, Kumru H, Laxe S, Edwards DJ, et al. TDCS does not enhance the effects of robot-assisted gait training in patients with subacute stroke. Restorative Neurology and Neuroscience 2017;35(4):377-84. [0922-6028]
Madhavan 2011 {published data only}
    1. Madhavan S, Weber KA, Stinear JW. Non-invasive brain stimulation enhances fine motor control of the hemiparetic ankle: implications for rehabilitation. Experimental Brain Research 2011;209(1):9-17.
Manganotti 2011 {published data only}
    1. Manganotti P, Daloli V, Fiaschi A. Decrease of upper limb spasticity after transcranial direct current stimulation in patients affected by stroke. In: Proceedings of the 14th European Congress of Clinical Neurophysiology and the 4th International Conference on Transcranial Magnetic and Direct Current Stimulation, Rome, Italy. 2011.
Montenegro 2016 {published data only}
    1. Montenegro RA, Midgley A, Massaferri R, Bernardes W, Okano AH, Farinatti P. Bihemispheric motor cortex transcranial direct current stimulation improves force steadiness in post-stroke hemiparetic patients: a randomized crossover controlled trial. Frontiers in Human Neuroscience 2016;10:426.
    1. TCTR20151112001. Non-invasive brain stimulation and physical training in stroke patients with motor impairments. (accessed 9 December 2019).
NCT03486769 {published data only}
    1. NCT03486769. Dual site-dual channel non-invasive brain stimulation for motor function in stroke patients. 2018.
Ochi 2013 {published data only}
    1. Ochi M, Saeki S, Oda T, Matsushima Y, Hachisuka K. Effects of anodal and cathodal transcranial direct current stimulation combined with robotic therapy on severely affected arms in chronic stroke patients. Journal of Rehabilitation Medicine 2013;45(2):137-40.
    1. Shiraishi J, Seeki S, Ochi M, Oda T, Matsushima Y, Yoshikawa K, et al. Combined robotic therapy with transcranial direct current stimulation. Cerebrovascular Diseases 2012;34 Suppl 1:132 (Abst PP-171).
Paquette 2011 {published data only}
    1. Paquette C, Radlinska B, Sidel M, Thiel A. Reducing transcallosal inhibition with non-invasive brain stimulation to improve post-infarct motor disorders. Movement Disorders 2011;26 Suppl 2:S40.
Picazio 2015 {published data only}
    1. Picazio S, Granata C, Caltagirone C, Petrosini L, Oliveri M. Shaping pseudoneglect with transcranial cerebellar direct current stimulation and music listening. Frontiers in Human Neuroscience 2015;9:158. [1662-5161]
Sheliakin 2006 {published data only}
    1. Sheliakin AM, Preobrazhenskaia IG, Tiul'kin ON. Micropolarization of the brain: a noninvasive method for correction of morphological and functional disturbances in acute focal brain lesions and their consequences. Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova 2006;106(10):27-37.
Stagg 2012a {published data only}
    1. Stagg C. Transcranial direct current stimulation - evidence for functional improvements in conjunction with brain activation changes in chronic stroke patients. Third UK Stroke Forum Conference 2008:6.
    1. Stagg CJ, Bachtiar V, O'Shea J, Allman C, Bosnell RA, Kischka U, et al. Cortical activation changes underlying stimulation-induced behavioural gains in chronic stroke. Brain 2012;135(Pt 1):276-84.
Takebayashi 2017 {published data only}
    1. Takebayashi T, Takahashi K, Moriwaki M, Sakamoto T, Domen K. Improvement of upper extremity deficit after constraint-induced movement therapy combined with and without preconditioning stimulation using dual-hemisphere transcranial direct current stimulation and peripheral neuromuscular stimulation in chronic stroke patients: a pilot randomized controlled trial. Frontiers in Neurology 2017;8:568.
Takeuchi 2012 {published data only}
    1. Takeuchi N, Tada T, Matsuo Y, Ikoma K. Low-frequency repetitive TMS plus anodal transcranial DCS prevents transient decline in bimanual movement induced by contralesional inhibitory rTMS after stroke. Neurorehabilitation and Neural Repair 2012;26(8):988-98.
Tang 2017 {published data only}
    1. Tang CW, Kuo IJ, Tsai YA, Lu YC, Lee IH. Neuromodulation by task-concurrent dual transcranial direct current stimulation over the motor cortex in subacute stroke. Neurology 2017;88(16 Suppl 1).
Vandermeeren 2015 {published data only}
    1. Vandermeeren Y, Dricot L, Laloux P, Desfontaines P, Evrard F, Peeters A, et al. Combining non-invasive brain stimulation (dual-tDCS) and motor skill learning induces a lasting increase of RS-fMRI functional connectivity in stroke patients. European Journal of Neurology 2015;22:36. [1351-5101]
Yao 2015 {published data only}
    1. Yao J, Drogos J, Veltink F, Anderson C, Zaa JCU, Hanson LI, et al. The effect of transcranial direct current stimulation on the expression of the flexor synergy in the paretic arm in chronic stroke is dependent on shoulder abduction loading. Frontiers in Human Neuroscience 2015;9. [1662-5161]
Zimerman 2012 {published data only}
    1. Zimerman M, Heise KF, Hoppe J, Cohen LG, Gerloff C, Hummel FC. Modulation of training by single-session transcranial direct current stimulation to the intact motor cortex enhances motor skill acquisition of the paretic hand. Stroke 2012;43(8):2185-91.
References to studies awaiting assessment Aze 2016 {published data only}
    1. Aze O, Ojardias E, Luneau D, Mednieks J, Condemine A, Giraux P. Transient effects of a single transcranial direct current stimulation (tDCS) on gait performance in chronic hemiplegic patients. 20th Conference of the International Functional Electrical Stimulation Society 2016.
    1. Ojardias E, Aze O, Luneau D, Mednieks J, Condemine A, Giraux P. Positive effects of tDCS cortical stimulation on the walking performance of chronic hemiplegic patients. Annals of Physical and Rehabilitation Medicine 2015;58:e1. [1877-0657]
Brem 2010 {published data only}
    1. Brem AK, Speight I, Jaencke L. Impact of tDCS on motor function in acute stroke. 6th World Congress of Neurorehabilitation 2010:123-7.
Miller 2013 {published data only}
    1. Miller J, Marquez J, Vliet P, Lagopoulos J, Parsons M. Transcranial Direct Current Stimulation: A randomised controlled trial to investigate the effects on upper limb function in chronic stroke. International Journal of Stroke 2013;8:22.
Park 2014 {published data only}
    1. Park E, Kwon TG, Chang WH, Kim YH. Non-invasive brain stimulation for motor function of chronic stroke patients. In: International Stroke Conference Poster Abstracts. 2014. [0039-2499]
References to ongoing studies ACTRN12613000109707 {published and unpublished data}
    1. ACTRN12613000109707. Standard upper limb therapy treatment with or without non-invasive brain stimulation to assist recovery after stroke. (accessed 5 March 2013).
ACTRN12616000254493 {published data only}
    1. ACTRN12616000254493. TOPS: Transcranial direct-current stimulation (tDCS) to optimise participation in stroke rehabilitation – a sham controlled cross over study. (accessed 9 December 2019).
ACTRN12618000443291 {published data only}
    1. Welsby E, Ridding M, Hillier S, Hordacre B. Connectivity as a predictor of responsiveness to transcranial direct current stimulation in people with stroke: protocol for a double-blind randomized controlled trial. Journal of Medical Internet Research 2018;20(10):127. [ACTRN12618000443291]
ACTRN12618001835235 {published data only}
    1. ACTRN12618001835235. Robot-assisted arm therapy and brain stimulation to enhance recovery after stroke. (accessed 9 December 2019).
ChiCTR1800014900 {published data only}
    1. ChiCTR1800014900. The effect of tDCS plus functional electrical stimulation on gait in patientis with stroke: A Prospective, Randomized Controlled Trial. (accessed 9 December 2019).
ChiCTR1800015881 {published data only}
    1. ChiCTR1800015881. Transcranial direct current stimulation for motor recovery of upper limb function after stroke: a multicenter randomized controlled trial. (accessed 9 December 2019).
ChiCTR1800018925 {published data only}
    1. ChiCTR1800018925. Therapeutic effect of transcranial direct current stimulation combined with functional electrical stimulation on lower limbs motor function in patients with stroke. (accessed 9 December 2019).
ChiCTR1800019386 {published data only}
    1. ChiCTR1800019386. Effects of virtual reality combined with transcranial direct current stimulation on upper limb function in patients with ischemic stroke. (accessed 10 December 2019).
ChiCTR1800020088 {published data only}
    1. ChiCTR1800020088. Comparing the effects of transcranial direct current stimulation (tDCS) as prior and concurrent motor priming combined with mirror therapy on the upper limb motor function recovery in chronic stroke patients: A pilot study. (accessed 10 December 2019).
ChiCTR‐ICR‐15006108 {published data only}
    1. ChiCTR-ICR-15006108. Effects of TDCS combined FES on upper limb function with severe chronic stroke patients. (accessed 10 December 2019).
ChiCTR‐IOR‐15006429 {published data only}
    1. ChiCTR-IOR-15006429. Effectiveness of transcranial direct current stimulation training in stroke. (accessed 10 December 2019).
ChiCTR‐TRC‐11001398 {published data only}
    1. ChiCTR-TRC-11001398. Effect of transcranial direct current stimulation on recovery of upper-limb function after stroke. (accessed 4 March 2013).
ChiCTR‐TRC‐11001490 {published data only}
    1. ChiCTR-TRC-11001490. Using transcranial direct current stimulation to treat ataxia and balance impairment after stroke. (accessed 4 March 2013).
CTRI/2017/01/007733 {published data only}
    1. CTRI/2017/01/007733. Very low current brain stimulation (transcranial direct current stimulation) to improve upper limb and lower limb weakness in stroke patients. (accessed 10 December 2019).
CTRI/2017/05/008668 {published data only}
    1. CTRI/2017/05/008668. Effect of dual-task exercise in conjunction with fluoxetine & Transcranial direct current stimulation (tDCS) on postural stability and gait in stroke patients. (accessed 10 December 2019).
CTRI/2018/04/013380 {published data only}
    1. CTRI/2018/04/013380. A study to assess the role of a minimal current applied over a specific area in head on muscle activity of weaker leg in patients with stroke. (accessed 10 December 2019).
Geiger 2017 {published data only}
    1. Geiger M, Supiot A, Zory R, Aegerter P, Pradon D, Roche N. The effect of transcranial direct current stimulation (tDCS) on locomotion and balance in patients with chronic stroke: study protocol for a randomised controlled trial. Trials 2017;18(1):492.
IRCT2013121715840N1 {published data only}
    1. IRCT2013121715840N1. Transcranial direct current stimulation (tDCS) and balance rehabilitation in stroke. (accessed 10 December 2019).
JPRN‐UMIN000020927 {published data only}
    1. JPRN-UMIN000020927. Examination of constraint-induced movement therapy combining with transcranial direct current stimulation and peripheral neuromuscular electrical stimulation. (accessed 10 December 2019).
JPRN‐UMIN000027980 {published data only}
    1. JPRN-UMIN000027980. Effects of transcranial direct-current stimulation and body-weight-supported treadmill training on gait recovery in hemiparetic patients after stroke. (accessed 10 December 2019).
JPRN‐UMIN000032300 {published data only}
    1. JPRN-UMIN000032300. The effects of transcranial direct current stimulation combined with functional electrical stimulation on gait performance in stroke patients. (accessed 10 December 2019).
JPRN‐UMIN000033324 {published data only}
    1. JPRN-UMIN000033324. The effects of gait training during transcranial direct current stimulation on ankle dorsiflexion in patinets with stroke. (accessed 10 December 2019).
JPRN‐UMIN000034721 {published data only}
    1. JPRN-UMIN000034721. Efficacy and safety of transcranial direct current stimulation in subacute ischemic stroke. (accessed 10 December 2019).
Levin 2018 {published data only}
    1. Levin MF, Banina MC, Frenkel-Toledo S, Berman S, Soroker N, Solomon JM, et al. Personalized upper limb training combined with anodal-tDCS for sensorimotor recovery in spastic hemiparesis: study protocol for a randomized controlled trial. Trials 2018;19(1) (no pagination).
NCT00542256 {published data only}
    1. NCT00542256. tDCS and physical therapy in stroke. (accessed 4 March 2013).
NCT00783913 {published data only}
    1. NCT00783913. Using transcranial direct current stimulation (tDCS) to enhance the benefit of movement training in stoke patients. (accessed 4 March 2013).
NCT00853866 {published data only}
    1. NCT00853866. Enhancement of motor function with reboxetine and transcranial direct current stimulation (STIMBOX). (accessed 4 March 2013).
NCT00909714 {published data only}
    1. NCT00909714. Neuroregeneration enhanced by transcranial direct current stimulation (TDCS) in stroke. (accessed 4 March 2013).
NCT01007136 {published data only}
    1. Hodics T, Cohen L, Upreti B, Alex A, Kowalske K, Hart J, et al. Enrollment in early brain stimulation arm motor recovery studies is limited primarily by stimulation-unrelated exclusions including ethnic and racial characteristics. Stroke 2012;43(2):(Abst 2439).
    1. Hodics T, Hidler J, Xu B, Kowalske K, Hart J, Briggs R, et al. Transcranial direct current stimulation (tDCS) enhanced stroke recovery and cortical reorganization. In: International Stroke Conference; San Antonio, Texas; February 23-26, 2010. [CENTRAL: CN-00747781]
    1. Hodics T, Upreti B, Alex A, Xu B, Hidler J, Kowalske K, et al. Transcranial direct current stimulation (tDCS) enhanced stroke recovery and cortical reorganization - an ongoing clinical trial. European Journal of Neurology 2011;18 Suppl 2:127.
    1. Hodics TM, Dromerick AW, Pezullo JC, Xu B, Hidler J, Hart J, et al. Transcranial direct current stimulation (tDCS) enhanced stroke recovery and cortical reorganization. In: Proceedings of the International Stroke Conference. Los Angeles, USA, 2012:(Abst CT P25).
    1. NCT01007136. Transcranial direct current stimulation (tDCS)-enhanced stroke recovery. (accessed 4 March 2013).
NCT01014897 {published data only}
    1. NCT01014897. Transcranial direct current stimulation (tDCS) in chronic stroke recovery. (accessed 4 March 2013).
NCT01127789 {published data only}
    1. NCT01127789. The use of transcranial direct current stimulation (tDCS) to study implicit motor learning on patients with brain injury [Withdrawn]. (accessed 4 March 2013).
NCT01143649 {published data only}
    1. NCT01143649. Use of transcranial direct current stimulation (tDCS) coupled with constraint induced movement therapy in stroke patients. (accessed 4 March 2013).
NCT01169181 {published data only}
    1. NCT01169181. AMES + brain stimulation: treatment for profound plegia in stroke. (accessed 7 September 2015).
NCT01207336 {published data only}
    1. NCT01207336. Combined tDCS + PNS after acute stroke. (accessed 4 March 2013).
NCT01356654 {published data only}
    1. NCT01356654. Transcranial direct current stimulation in stroke rehabilitation. (accessed 4 March 2013).
NCT01405378 {published data only}
    1. NCT01405378. Non-invasive brain stimulation for people with stroke. (accessed 9 December 2019).
NCT01500564 {published data only}
    1. Kandel M, Beis JM, Ganis V, Prestini M, Paysant J, Jacquin-Courtois S. Transcranial direct current stimulation associated with physical therapy after stroke: feasability of a prospective, randomised, double blinded, sham controlled study. Annals of Physical and Rehabilitation Medicine 2011;54:e234.
    1. NCT01500564. Functional interest of non invasive brain stimulation during physiotherapy at a subacute phase post stroke (anodal protocol): ReSTIM. (accessed 4 March 2013).
NCT01503073 {published data only}
    1. NCT01503073. Noninvasive brain stimulation for stroke. (accessed 4 March 2012).
NCT01519843 {published data only}
    1. NCT01519843. Post stroke motor learning. (accessed 4 March 2013).
NCT01544699 {published data only}
    1. NCT01544699. Impact of non-invasive brain stimulation on motor recuperation. (accessed 4 March 2013).
NCT01574989 {published data only}
    1. NCT01574989. Effects of rTMS and tDCS on motor function in stroke. (accessed 4 March 2013).
NCT01644929 {published data only}
    1. NCT01644929. Rehabilitation combined with bihemispheric transcranial direct current stimulation in subacute ischemic stroke (RECOMBINE). (accessed 4 March 2013).
NCT01726673 {published data only}
    1. NCT01726673. Robots paired with tDCS in stroke recovery. (accessed 4 March 2012).
NCT01807637 {published data only}
    1. NCT01807637. Transcranial direct current stimulation for improving gait training in stroke. (accessed 7 September 2015).
NCT01828398 {published data only}
    1. NCT01828398. tDCS and robotic therapy in stroke. (accessed 7 September 2015).
NCT01847157 {published data only}
    1. NCT01847157. Transcranial direct current stimulation combined sensory modulation intervention in chronic stroke patients. (accessed 10 December 2019).
NCT01883843 {published data only}
    1. NCT01883843. Efficacy of TOCT and (tDCS) for gait improvement in patients with chronic stroke. (accessed 7 September 2015).
NCT01897025 {published data only}
    1. NCT01897025. Combined transcranial direct current stimulation and motor imagery-based robotic arm training for stroke rehabilitation. (accessed 7 September 2015).
NCT01907737 {published data only}
    1. NCT01907737. Combined brain and peripheral nerve stimulation for stroke. (accessed 10 December 2019).
NCT01969097 {published data only}
    1. NCT01969097. Efficacy basics of bihemispheric motorcortex stimulation after stroke. (accessed 7 September 2015).
NCT01983319 {published data only}
    1. NCT01983319. Transcranial direct current stimulation combined with constraint induced movement therapy and role of GABA activity in stroke recovery. (accessed 7 September 2015).
NCT02080286 {published data only}
    1. NCT02080286. Transcranial stimulation (tDCS) and prism adaptation in spatial neglect rehabilitation. (accessed 7 September 2015).
NCT02109796 {published data only}
    1. NCT02109796. Effects of tDCS on quadriceps strength after stroke. (accessed 7 September 2015).
NCT02134158 {published data only}
    1. NCT02134158. Impact of tDCS on locomotion and equilibrium in hemiplegic patients. (accessed 10 December 2019).
NCT02156635 {published data only}
    1. NCT02156635. Stroke treatment associate to rehabilitation therapy and transcranial DC stimulation. (accessed 7 September 2015).
NCT02166619 {published data only}
    1. NCT02166619. tDCS in poststroke on upper limb rehabilitation. (accessed 7 September 2015).
NCT02209922 {published data only}
    1. NCT02209922. The effects of tDCS combined with balance training on postural control and spasticity in chronic stroke patients. (accessed 7 September 2015).
NCT02210403 {published data only}
    1. NCT02210403. The influence of tDCS on the arm and hand function in stroke patients. (accessed 7 September 2015).
NCT02213640 {published data only}
    1. NCT02213640. Potentiation of the effects of prismatic adaptation by transcranial direct current stimulation (tDCS): evaluation of functional interest in negligence rehabilitation. (accessed 7 September 2015).
NCT02254616 {published data only}
    1. NCT02254616. Hybrid approach to mirror therapy and transcranial direct current stimulation for stroke recovery. (accessed 7 September 2015).
NCT02292251 {published data only}
    1. NCT02292251. Study to enhance motor acute recovery with intensive training after stroke. (accessed 7 September 2015).
NCT02308852 {published data only}
    1. NCT02308852. Improving bi-manual activities in stroke patients with application of neuro-stimulation. (accessed 7 September 2015).
NCT02325427 {published data only}
    1. NCT02325427. Changes in brain activity associated with upper limb motor recovery. (accessed 7 September 2015).
NCT02389608 {published data only}
    1. NCT02389608. The immediate effect of electrical stimulation transcranial direct current (tDCS) associated with the use of FES, in muscle activity of the tibialis anterior muscle, balance and plantar pressure distribution of individuals with hemiparesis due to stroke. (accessed 7 September 2015).
NCT02393651 {published data only}
    1. NCT02393651. Late LTP-like plasticity effects of tDCS in subacute stroke patients. (accessed 7 September 2015).
NCT02398344 {published data only}
    1. NCT02398344. tDCS immediate effect on cardiorespiratory parameters in hemiparetics adults patients due to stroke. 2015.
NCT02399540 {published data only}
    1. NCT02399540. Late LTP-like plasticity effects of tDCS in chronic stroke patients. (accessed 7 September 2015).
NCT02401724 {published data only}
    1. NCT02401724. NonInvasive brain stimulation in stroke patients. (accessed 7 September 2015).
NCT02416791 {published data only}
    1. NCT02416791. Robotic therapy and transcranial direct current stimulation in patients with stroke. (accessed 7 September 2015).
NCT02422173 {published data only}
    1. NCT02422173. Transcranial direct current stimulation on the risk of falls and lower limb function for acute stroke. (accessed 7 September 2015).
NCT02455427 {published data only}
    1. NCT02455427. Safety of transcranial direct current stimulation in the subacute phase after stroke. (accessed 7 September 2015).
NCT02512289 {published data only}
    1. NCT02512289. Impact of non-invasive brain stimulation, associated with upper limb robot-assisted therapy, on motor recuperation. (accessed 9 December 2019).
NCT02610387 {published data only}
    1. NCT02610387. The effects of tDCS combined with balance training on lower limbs spasticity in chronic stroke patients. (accessed 9 December 2019).
NCT02725853 {published data only}
    1. NCT02725853. Enhancing recovery of arm movement in stroke patients. 2016.
NCT02731508 {published data only}
    1. NCT02731508. Repetitive bihemispheric transcranial direct current stimulation after stroke. 2016.
NCT02806856 {published data only}
    1. NCT02806856. tDCS in acute stroke patients. 2016.
NCT02817867 {published data only}
    1. NCT02817867. Association between brain stimulations for the rehabilitation of chronic stroke patients. (accessed 9 December 2019).
NCT02821884 {published data only}
    1. NCT02821884. Combine transcranial direct current stimulation and neuromuscular electrical stimulation on stroke patients. 2016.
NCT02827864 {published data only}
    1. NCT02827864. Efficacy and time dependent effects of tDCS combined with MT for rehabilitation after subacute and chronic stroke. 2016.
NCT02892084 {published data only}
    1. NCT02892084. Augmentation of locomotor adaptation post-stroke. 2016.
NCT02892097 {published data only}
    1. NCT02892097. Transcranial direct current stimulation (tDCS) and task-specific practice for post-stroke neglect. 2016.
NCT02915185 {published data only}
    1. NCT02915185. Brain stimulation and tailored interventions to promote recovery in stroke survivors. 2016.
NCT02920333 {published data only}
    1. NCT02920333. Efficacy of the non-invasive brain stimulation techniques for lower limb recovery in stroke patients. 2016.
NCT02960009 {published data only}
    1. NCT02960009. Motor excitability study of high definition transcranial direct current stimulation (HD-tDCS) in chronic stroke. 2016.
NCT02987361 {published data only}
    1. NCT02987361. Effect of tDCS on upper extremity after strokes. 2016.
NCT03026712 {published data only}
    1. NCT03026712. Hemiparetic arm robotic mobilization with non invasive electrical stimulation. 2017.
NCT03092570 {published data only}
    1. NCT03092570. Manual dexterity control after cerebellar stimulation. (accessed 10 December 2019).
NCT03093142 {published data only}
    1. NCT03093142. The treatment effectiveness of combined tDCs and neurofeedback (NF) for patients with cognitive deficits after stroke. 2017.
NCT03122821 {published data only}
    1. NCT03122821. Transcranial brain stimulation for stroke rehabilitation. (accessed 10 December 2019).
NCT03124147 {published data only}
    1. NCT03124147. Optimizing transcranial direct Current stimulation for motor recovery from hemiparesis. 2017.
NCT03144102 {published data only}
    1. NCT03144102. Combining tDCS with VR-based motor training in stroke. 2017.
NCT03230695 {published data only}
    1. NCT03230695. Robotic therapy and brain stimulation in the early phase after stroke. (accessed 10 December 2019).
NCT03317860 {published data only}
    1. NCT03317860. Improving measurement and treatment of post-stroke neglect. 2017.
NCT03342534 {published data only}
    1. NCT03342534. Effect of tDCS on brain organization and motor recovery. 2017.
NCT03390192 {published data only}
    1. NCT03390192. Noninvasive dual-mode stimulation therapy for neurorehabilitation in stroke. 2018.
NCT03446378 {published data only}
    1. NCT03446378. tDCS on motor rehabiliation of post stroke patients. 2018.
NCT03452254 {published data only}
    1. NCT03452254. NIBS with mCIMT for motor and functional upper limb recovery in stroke patients. 2018.
NCT03460886 {published data only}
    1. NCT03460886. Most effective stimulation site in transcranial direct current stimulation for gait recovery after stroke. 2018.
NCT03465631 {published data only}
    1. NCT03465631. Upper extremity rehabilitation using SMART Glove system with transcranial direct current stimulation. (accessed 10 December 2019).
NCT03492229 {published data only}
    1. NCT03492229. Cortical priming to optimize gait rehabilitation post stroke. (accessed 10 December 2019).
NCT03528018 {published data only}
    1. NCT03528018. Efficacy of a combined transcranial direct current stimulation and virtual reality intervention. 2018.
NCT03562663 {published data only}
    1. NCT03562663. Brain stimulation and robotics in chronic stroke motor recovery. (accessed 10 December 2019).
NCT03574038 {published data only}
    1. NCT03574038. Transcranial direct current stimulation as a neuroprotection in acute stroke. (accessed 10 December 2019).
NCT03708016 {published data only}
    1. NCT03708016. Effect of robot gait training with brain stimulation on gait function in stroke patients. (accessed 10 December 2019).
NTR3315 {published data only}
    1. NTR3315. The effect of non invasive brain stimulation on lower limb motor skill acquisition. (accessed 4 March 2013).
NTR5261 {published data only}
    1. NTR5261. Improving standing balance after stroke with tDCS and postural feedback therapy. (accessed 10 December 2019).
NTR5757 {published data only}
    1. NTR5757. The offline effects of brain stimulation (transcranial direct current stimulation, tDCS) on postural balance control after stroke. (accessed 9 December 2019).
NTR5828 {published data only}
    1. NTR5828. The offline effects of brain stimulation (type tDCS) on balance control after stroke. (accessed 9 December 2019).
PACTR201803003148269 {published data only}
    1. PACTR201803003148269. Effect of transcranial direct current stimulation combined with constraint-induced movement therapy on cortical reorganization and functional outcome. (accessed 9 December 2019).
Paolucci 2017 {published data only}
    1. Paolucci M, Morone G, Capone F, Musumeci G, Gallinelli F, Mammucari E. Association of dual transcranial electrical stimulation (tDCS) to upper limb robotic therapy in patients with chronic stroke. European Stroke Journal 2017;2 Suppl 1:329.
Paquette 2013 {published data only}
    1. Paquette C, Riegel M, Anglade C, Fung J, Thiel A. Early inhibitory non-invasive brain stimulation of the unaffected hemisphere combined improves motor outcome in acute stroke. Cerebrovascular Diseases 2013;35:147-8. [1015-9770]
RBR‐22rh3p {published data only}
    1. RBR-22rh3p. Non-invasive brain stimulation and physical training in stroke patients with motor impairments. (accessed 9 December 2019).
RBR‐25xyqp {published data only}
    1. RBR-25xyqp. The use of transcranial electrical current stimulation and physical therapy exercise for rehabilitation of patients after stroke. (accessed 10 December 2019).
Sattler 2012 {published data only}
    1. Sattler V, Acket B, Gerdelat-Mas A, Raposo N, Albucher JF, Thalamas C, et al. Effect of repeated sessions of combined anodal tDCS and peripheral nerve stimulation on motor performance in acute stroke: a behavioural and electrophysiological study [Effet sur la recuperation motrice post-AVC, en phase aigue, de sessions repetees de tDCS anodale du cortex moteur primaire couplee a une stimulation electrique peripherique repetitive]. Annals of Physical and Rehabilitation Medicine 2012;55:e3 + e5-e6. [1877-0657]
TCTR20160606003 {published data only}
    1. TCTR20160606003. Transcranial direct current stimulation modulates EEG signals of brain computer interface in stroke patients: a randomized controlled pilot study. (accessed 9 December 2019).
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