Effect of tDCS on Fine Motor Control of Patients in Subacute and Chronic Post-Stroke Stages

Figures & data

Figure 1. (A) Time course of the study. (B) Time course of one study session. JTT – Jebsen–Taylor Hand function test.

Figure 2. The mean total time of Jebsen–Taylor Hand function test during ten sessions of training.   - mean, vertical bars denote 0.95 confidence intervals.

TABLE 1. Clinical characteristics of the patients.

	Sex	Age	Pares side	Days after stroke^a	Paresis degree subacute^b (0–5)	Paresis degree chronic^b (0–5)	Total JT baseline^c	Stroke type (Cortical/Subcortical
Patient 1	F	62	L	22	4.5	4.5	33.7	ischemic (C)
Patient 2	M	65	R	23	4.0	4.5	43.8	hemorrhagic (S)
Patient 3	F	66	L	20	3.5	4.0	59.1	ischemic (S)
Patient 4	M	70	L	23	4.5	4.5	29.0	ischemic (C)
Patient 5	M	74	L	25	3.5	4.5	43.6	ischemic (C)
Patient 6	M	69	L	27	4.0	4.5	38.3	ischemic (S)
Patient 7	F	72	L	26	4.5	4.5	27.8	ischemic (S)
Patient 8	F	62	L	24	4.5	4.5	26.8	ischemic (C)
Patient 9	F	68	L	26	4.5	4.0	34.9	hemorrhagic (S)
Patient 10	F	65	L	28	3.5	4.0	54.6	hemorrhagic (S)
Patient 11	F	72	L	23	4.5	4.5	28.8	ischemic (S)
Patient 12	M	68	R	27	4.0	4.5	44.4	ischemic (S)
Patient 13	M	67	L	22	3.5	4.0	55.9	hemorrhagic (S)

^a Days after stroke at the beginning of the study.

^b 0 – no movement, 5 – full recovery; assessed before first session.

^c Mean total baseline JT time; was calculated for four baseline times in four sessions: (B1 + B2 + B3 + B4)/4.

Figure 3. Inverted mean percent change of the total JTT time relative to baseline (positive values represent improved performance). Significant interaction between type of stimulation, stage of stroke and time of the test performance was observed (repeated-measure ANOVA, F(1,12) = 7.39, p = 0.02). Relevant post-hoc comparisons (Fisher LSD test) are shown. * p < 0.05. **p < 0.01, ***p < 0.001.

TABLE 2. Results of ANOVA.

	d.f.	F-value	p-value
STAGE	1	1.49	0.25
TYPE	1	9.99	0.008*
TIME	1	15.10	0.002*
TIME*TYPE	1	4.20	0.06
TIME*STAGE	1	3.76	0.08
STAGE*TYPE	1	1.71	0.22
STAGE*TYPE*TIME	1	7.39	0.02*

The repeated-measure ANOVA of the inverted percent change of the total JTT time relative to baseline. Asterisks indicate significant results (p < 0.05). d.f. – degrees of freedom.

TABLE 3. Mean time and percent of improvement of the subtests performance in different conditions.

	Baseline	During tDCS		After tDCS
Subtest	sec (SD)	sec (SD)	% change	sec (SD)	% change
Subacute stage
Sham tDCS
Turning cards	6.44 (2.41)	6.27 (2.36)	2.81	6.22 (2.28)	3.28
Picking up small objects	9.31 (2.22)	9.21 (2.17)	1.00	9.25 (2.15)	0.43
Stacking checkers	6.28 (1.97)	6.21 (1.96)	1.11	6.15 (2.01)	2.40
Picking up beans	9.28 (2.65)	9.29 (2.56)	−0.41	9.38 (2.52)	−1.74
Lifting light cans	5.68 (1.76)	5.56 (1.66)	1.88	5.53 (1.57)	1.65
Lifting heavy cans	5.53 (1.71)	5.45 (1.66)	−0.76	5.45 (1.67)	0.95
Anodal tDCS
Turning cards	5.97 (2.28)	6.00 (2.01)	−2.40	5.86 (2.03)	0.60
Picking up small objects	9.19 (2.15)	8.79 (2.22)	4.70	8.51 (2.45)	8.41
Stacking checkers	6.14 (1.83)	5.91 (1.84)	4.10	5.74 (1.98)	7.70
Picking up beans	9.23 (2.43)	9.09 (2.44)	1.76	8.93 (2.44)	3.57
Lifting light cans	5.70 (1.69)	5.54 (1.70)	3.16	5.36 (1.76)	6.69
Lifting heavy cans	5.37 (1.66)	5.31 (1.67)	1.22	5.07 (1.66)	5.90
Chronic stage
Sham tDCS
Turning cards	6.49 (2.14)	5.96 (2.05)	7.57	5.81 (2.01)	9.61
Picking up small objects	9.04 (1.90)	8.61 (2.17)	5.14	8.52 (2.25)	6.26
Stacking checkers	6.04 (1.75)	5.93 (1.76)	1.92	5.80 (1.74)	4.08
Picking up beans	9.00 (2.09)	8.86 (2.10)	1.59	8.77 (2.05)	2.39
Lifting light cans	5.47 (1.62)	5.32 (1.58)	2.51	5.34 (1.53)	1.98
Lifting heavy cans	5.27 (1.59)	5.22 (1.57)	0.80	5.19 (1.64)	1.62
Anodal tDCS
Turning cards	5.80 (2.06)	5.59 (2.05)	3.96	5.60 (2.06)	3.79
Picking up small objects	8.50 (2.20)	8.16 (2.19)	4.10	8.22 (2.11)	2.88
Stacking checkers	5.74 (1.84)	5.51 (1.80)	4.28	5.43 (1.85)	5.87
Picking up beans	8.67 (2.15)	8.40 (2.12)	3.20	8.37 (2.14)	3.55
Lifting light cans	5.27 (1.69)	5.05 (1.69)	4.49	5.08 (1.69)	3.86
Lifting heavy cans	5.10 (1.72)	4.94 (0.47)	3.18	4.93 (1.67)	3.33

Figure 4. Inverted percent change of the total JTT time relative to baseline (positive values represent improved performance) in individual patients (eight measurements with JTT in four sessions).

Figure 5. Inverted mean percent change of the total JTT time relative to baseline in Group 1 (A) and Group 2 (B). Repeated-measure ANOVA with factors STAGE, TYPE; TIME and GROUP (F(1,11) = 35.4; p = 0.0001). Relevant post-hoc comparisons (Fisher LSD test) are shown. *p < 0.05. **p < 0.01, ***p < 0.001.