Reduction of Spasticity in Cerebral Palsy by Anodal
Transcranial Direct Current Stimulation
Benchaporn Aree-uea MSc*,
Narong Auvichayapat MD**, Taweesak Janyacharoen PhD***, Wantana Siritaratiwat PhD***,
Anuwat Amatachaya DVM*, Jitlada Prasertnoo MSc****, Orathai Tunkamnerdthai MSc*,
Bandit Thinkhamrop PhD*****, Mark P Jensen PhD******, Paradee Auvichayapat MD*
Affiliation :
* Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
** Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
*** Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
**** Physical Therapist of Srisangwal School, Khon Kaen, Srisangwal School, Khon Kaen, Thailand
***** Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Thailand
****** Department of Rehabilitation Medicine, University of Washington, Seattle, USA
Objective : To evaluate the anti-spasticity effects of anodal transcranial direct current stimulation (tDCS) in individuals
with spastic cerebral palsy (CP).
Material and Method: Forty-six children and adolescents with cerebral palsy were randomly assigned to either active
(1 mA anodal) or sham (placebo) tDCS over the left primary motor cortex (M1) on five consecutive days. Both group also
received routine physical therapy. Measures of spasticity and passive range of motion (PROM) were administered before
treatment, immediately after treatment, and at 24- and 48-hours follow-up.
Results : Participants assigned to active tDCS treatment evidenced significantly more pre- to immediately post-treatment
reductions in spasticity than participants assigned to the sham (p = 0.004, p<0.001, and p = 0.004 for shoulder, wrist, and
fingers respectively) and these improvement in spasticity maintained for at least 48 hours for wrist joints (p = 0.023). There
was only one participant in the active tDCS condition developed erythematous rash. However, all participants tolerated
the tDCS well without any serious adverse events.
Conclusion : Anodal tDCS appeared to reduce CP-related spasticity (but not PROM) in the short term. Researches examine
the long term benefits of this intervention on spasticity are warranted.
Keywords : Cerebral palsy, Spasticity, Transcranial direct current stimulation, Noninvasive brain stimulation, Children
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