Objectives: To evaluate the effect of Transcranial Direct Current Electrostimulation (TDCS) on Unilateral Spatial Neglect (USN) after stroke in the right hemisphere and to compare the effectiveness of anodic, cathodic and sham modality.
Design: Clinical trial, randomized, double-blind and multicenter study. Subjects diagnosed with stroke (minimum 3 weeks and maximum 1 year) in the right parietal lobe, confirmed by imaging examination and diagnosed with USN were included (score below 129 on the gold standard for diagnosis of USN, Behavior lnnatention Test - BIT). . Patients were randomized into 3 groups: 1 - P4 anodic stimulation (right parietal); 2 - P3 cathodic stimulation (left parietal); 3 - sham group. All patients received physical therapy immediately after stimulation, twice a week, totaling 15 sessions. The evaluator was blinded to treatment. The BIT was applied on the first (D1) and fifteenth (D15) day of stimulation.
Results: Of the 779 patients identified with stroke within 15 months, 37 met the inclusion criteria after screening. Of these, four were excluded. The 33 patients who completed the protocol were randomized into: Anodic (n = 11), Cathodic (n = 11) and Sham (n = 11) stimulation. The 3 groups showed improvement in NEU after treatment; however, patients in the anodic stimulation group had better results in the BIT evaluation at D15, with statistical difference between groups (p = 0.02). There was no statistical significance when comparing the evolution of D1 to D15 (p > 0.05).
Conclusions: Anodic TDCS in the right parietal region seems to have a beneficial effect in the treatment of post-stroke NEU, but these are partial results, with incomplete sample size. Improvement of NEU, regardless of treatment group, is due to physical therapy and seems to be optimized with anodic stimulation.
Tais Silva– Physiotherapist, University Estadual Paulista Júlio de Mesquita Filho, São Paulo, Brazil
Laís G. Martins– Physiotherapist, FMB - UNESP
Rafael D. M. Costa– Physiotherapist, FMB - UNESP
Gabriel Pinheiro Modolo– Physician, Hospital das Clínicas da Faculdade de Medicina de Botucatu
Lorena C. A. Sartor– Physiotherapist, FMB - UNESP
Helio Rubens– statistical, FMB - UNESP
Guilherme F. Borges– Student Medicine, FMB - UNESP
Josiela C. S. Rodrigues– Physioterapist, HCFMB- UNESP
Silmeia G. Z. Bazan– Doctor, FMB - UNESP
Juli T. Souza– Nutricionist, FMB - UNESP
Gustavo Luvizutto– Professor, Federal University of Triangulo Mineiro
Rodrigo Bazan– Doctor, FMB - UNESP