• Physical Therapy Rehabilitation Science
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• v.9 no.4
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• pp.318-323
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• 2020

Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.155-164
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• 2021

Purpose : The purpose of this study is to investigate the effects of transcranial direct current stimulation and virtual reality program application on cognition and depression of patients with mild cognitive impairment, and to find an intervention method that can enhance active participation of patients with mild cognitive impairment. Methods : In this study, 50 mild cognitive impairment patients were divided into a treatment group (25 patients) and a control group (25 patients). The treatment group was applied with a transcranial direct current stimulation and a virtual reality program, while the control group received a placebo transcranial direct current stimulation and a virtual reality program. Both groups received five 50-minute sessions per week (one session per day) for six weeks (total of 30 sessions). NCSE was used to evaluate the cognitive functions of the patients before and after treatment intervention. Moreover, K-BDI was conducted to examine the depression of the patients. Results : As a result of the transcranial direct current stimulation and a virtual reality program intervention, the cognitive function of both treatment and control group significantly (p<.05) improved, and the depression of both treatment and control group significantly (p<.05) decreased. Moreover, the changes in cognitive functions and depression were significant between the two groups¸ treatment and control group (p<.05). Conclusion : The results of the study showed that the application of the transcranial direct current stimulation and virtual reality program significantly improved the cognitive function of mild cognitive impairment patients and decreased the depression of them. Therefore, it could be concluded that the transcranial direct current stimulation and virtual reality program was an intervention method which positively affects the cognitive function and depression of mild cognitive impairment patients.

• The Journal of Korean Physical Therapy
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• v.36 no.1
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• pp.39-44
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• 2024

Purpose: Cybersickness is a type of motion sickness induced by virtual reality (VR) or augmented reality (AR) environments that presents symptoms including nausea, dizziness, and headaches. This study aimed to investigate how cathodal transcranial direct current stimulation (tDCS) alleviates motion sickness symptoms and modulates brain activity in individuals experiencing cybersickness after exposure to a VR environment. Methods: This study was performed on two groups of healthy adults with cybersickness symptoms. Subjects were randomly assigned to receive either cathodal tDCS intervention or sham tDCS intervention. Brain activity during VR stimulation was measured by 38-channel functional near-infrared spectroscopy (fNIRS). tDCS was administered to the right temporoparietal junction (TPJ) for 20 minutes at an intensity of 2mA, and the severity of cybersickness was assessed pre- and post-intervention using a simulator sickness questionnaire (SSQ). Result: Following the experiment, cybersickness symptoms in subjects who received cathodal tDCS intervention were reduced based on SSQ scores, whereas those who received sham tDCS showed no significant change. fNIRS analysis revealed that tDCS significantly diminished cortical activity in subjects with high activity in temporal and parietal lobes, whereas high cortical activity was maintained in these regions after intervention in subjects who received sham tDCS. Conclusion: These findings suggest that cathodal tDCS applied to the right TPJ region in young adults experiencing cybersickness effectively reduces motion sickness induced by VR environments.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.2
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• pp.101-108
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• 2023

Purpose : To investigate effects of transcranial directed current stimulus (tDCS) combined with abdominal draw-in maneuver (ADIM) on balance ability and trunk impairment scale of chronic stroke patients. Methods : Twenty-six chronic stroke patients were recruited and twenty-four participated after excluding two patients who met the exclusion criteria. After screening tests, they were randomized through excel program into an experimental group (n = 12) to apply a tDCS combined with ADIM and a control group (n = 12) to apply a sham tDCS with ADIM. The intervention lasted three times a week for six weeks. To compare tDCS intervention effects, trunk impairment scale and balance ability were measured. Comparisons between experimental and control groups were statistically processed using an independent t-test and comparisons within groups were statistically processed using a paired t-test. Results : The experimental group showed significant increases of pre- and post-intervention medial lateral velocity, anterior posterior velocity and area of balance ability, and trunk impairment scale (p<.05). The control group showed significant increases in pre- and post-intervention medial lateral velocity of balance ability and trunk impairment scale (p< .05). The experimental group showed significant increases of medial lateral velocity of balance ability and trunk impairment scale compared to the control group (p<.05). Conclusion : Results of this study suggest that tDCS combined with ADIM for chronic stroke patients can be effective in improving medial lateral velocity of balance ability and trunk impairment scale. Thus, tDCS can be used as an effective treatment protocol for trunk rehabilitation of chronic stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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• pp.53-62
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• 2023

Purpose : This study evaluated the effects of transcranial direct current stimulation and a virtual reality program on the depression, hand functions, cognitive function, and activities of daily living of patients with mild cognitive impairment by dividing 20 patients with mild cognitive impairment and depression. The 20 patients were divided into a treatment group (transcranial direct current stimulation + a virtual reality program) and a control group (placebo transcranial direct current stimulation + a placebo virtual reality program). Methods : This study allocated ten subjects to the treatment group and ten subjects to the control group. The treatment was given five times per week for six weeks (30 sessions), and each session was 30 minutes. This study screened depression by using SGDS-K, a short geriatric depression scale, to examine depression before and after treatment intervention. This study also used the box and block test, NCSE, and FIM to evaluate hand functions, cognitive function, and activities of daily living, respectively. Results : The results showed that depression significantly decreased, hand functions significantly increased, cognitive function significantly improved, and activities of daily living significantly increased after intervention in the treatment and control groups. The magnitude of changes in depression, hand functions, cognitive function, and activities of daily living was significantly different between the two groups after intervention (p>.05). Conclusion : The results showed that the application of transcranial direct current stimulation and a virtual reality program could improve cognitive function, hand functions, and activities of daily living by decreasing depression. Therefore, it can be concluded that the simultaneous application of transcranial direct current stimulation and a virtual reality program is an intervention method, which can be applied for decreasing depression, enhancing hand functions, improving cognitive function, and increasing activities of daily living in patients with mild cognitive impairment.

• Korean Journal of Applied Biomechanics
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• v.32 no.3
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• pp.94-102
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• 2022

Objective: The purpose of this study was to investigate the effect of acute transcranial direct current stimulation (tDCS) on the isokinetic muscular endurance of the lower extremity for young adults. Method: Thirteen young adults performed isokinetic fatigue tasks for two experimental conditions including real tDCS and sham stimulation protocols. Before and after the task, the tensiomyography was used for evaluating muscle contraction characteristics of vastus medialis and semitendinosus. Paired t-test was performed to compare the fatigue index, changes in maximum radial displacement (∆Dm), delay time (∆Tc), and velocity of contraction (∆Vc) between tDCS conditions. Results: We found no significant differences in the fatigue index between real and sham conditions. In addition, the analyses identified no significant different values of ∆Dm, ∆Tc, and ∆Vc in the vastus medialis and semitendinosus between real and sham conditions. Conclusion: These findings suggest that the tDCS protocols may have no acute effect on lower limb muscle endurance for young adults. Future studies should consider the long-term effects of repetitive tDCS sessions, various stimulation positions, exercise tasks, and participant characteristics to more clearly understand the effect of tDCS on muscle endurance of lower extremities.

• Korean Journal of Biological Psychiatry
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• v.24 no.4
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• pp.167-174
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• 2017

Based on advances in biotechnology and neuroscience, neuromodulation is poised to gain clinical importance as a treatment modality for psychiatric disorders. In addition to old-established electroconvulsive therapy (ECT), clinicians are expected to understand newer forms of neurostimulation, such as deep brain stimulation (DBS), vagus nerve stimulation (VNS), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS). Given the growing interest in non-invasive neuromodulation technologies, clinicians may seek sufficient information about neuromodulation to inform their clinical practice. A growing literature suggests that applications of non-invasive neuromodulation have evidence particularly for indications where treatments are currently insufficient, such as drug-resistant depression. However, positive neuromodulation studies require replication, and the precise interactions among stimulation, antidepressant medication, and psychotherapy are unknown. Further studies of long-term safety and the impact on the developing brain are needed. Non-invasive neuromodulatory devices could enable more individualized treatment. However, do-it-yourself (DIY) stimulation kits require a better understanding of the effects of more frequent patterns of stimulation and raise concerns about clinical supervision, regulation, and reimbursement. Wide spread enthusiasm for therapeutic potential of neuromodulation in clinical practice settings should be mitigated by the fact that there are still research gaps and challenges associated with non-invasive neuromodulatory devices.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.103-108
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• 2010

Purpose: The aim of this study is to investigate whether motor cortex excitability by transcranial direct current stimulation (tDCS) over primary motor cortex (M1) affects motor performance of serial reaction task. Methods: Cathodal, anodal and sham tDCS (1 mA) are applied over right M1 of 24 subjects for 30 minutes including 11minutes for task period time. We applied two electrodes at the same position to both an experimental group and a sham-controlled group, and we made 2 groups recognize to be applicated of stimulation. Flexion, extension of wrist and thumb flexion are carried out following colors of arrows on the monitor. Serial reaction time task was applied to confirm the difference of the reaction time between 2 groups. Results: Reaction time is decreased in both tDCS-group and Sham-controlled tDCS group, and the degree of reduction is much greater in the post-test than pre-test. Reduction of reaction time between groupsis statistically significant. Conclusion: We consider that anodal tDCS increased the cortical excitability of the underlying motor cortex and it can be helpful to modulate motor performance. It seems that tDCS is an effective modality to modulate brain function, and it will be great help to mediate strategy for the brain injury patients.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.8-15
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• 2022

Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.

• Journal of Sleep Medicine
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• v.15 no.2
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• pp.37-42
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• 2018

Objectives: To assess the effect and safety of transcranial direct-current stimulation (tDCS) in primary chronic insomnia. Methods: A one-month, double-blind, randomized, sham-controlled trial was performed. A total of 7 patients with primary chronic insomnia received tDCS using anodal (n=3), cathodal (n=2), or sham stimulation (n=2). They were followed up at 1 week and 1 month after treatment. The primary outcome measures included improvement in total sleep time (TST), sleep latency (SL), and sleep efficiency (SE) at 1 month follow-up. Results: TST and SE were improved with tDCS at 1 month follow-up in all patients (100%) of the anodal group, one (50%) of the cathodal group, and one (50%) of the sham group. tDCS improved SL at 1 month follow-up in two patients (67%) of the anodal group, one (50%) of the cathodal group, and none (0%) of the sham group. With respect to adverse events, transient itching sensation occurred in one patient of the anodal group. None of the other groups reported adverse events. Conclusions: Our results suggest that tDCS may be effective and safe for treatment of primary chronic insomnia. A larger controlled study needs to be further investigated.