Authors: Jude John Dsouza, Leah Mohandas
Background: Stroke is defined as abrupt onset neurological disorder of vascular aetiology. Stroke represented 1.2% of total deaths in India. Upper extremity paresis is a leading cause of functional disability after a stroke as it causes difficulty in everyday life. Decreased corticospinal excitability of lesioned hemisphere is a well recognized neurophysiological consequence after stroke. The level of excitability of affected hemisphere correlates with motor function and predicts recovery. Transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) have gained popularity in the stroke rehabilitation literature. Aims and Objectives: To compare the effects of transcranial direct current stimulation and repetitive transcranial magnetic stimulation on corticospinal excitability in chronic stroke. Materials and Methods: A thorough electronic search was made through various databases such as PubMed, ScienceDirect and Google Scholar. The total number of articles included were 20 of which 8 were RCTs, 2 systematic reviews, 3 literature reviews, 4 experimental studies and 3 crossover trials. Conclusion: tDCS has therapeutic applications in restoring the interhemispheric balance between the unlesioned and lesioned hemisphere, hence alleviating symptoms such as apraxia, spatial neglect, and gait. tDCS can also be used along with other peripheral intervention techniques such as occupational therapy, robot-assisted arm therapy and physical therapy to accelerate recovery in chronic stroke patients. On the other hand, rTMS has been used as an evaluative, prognostic (along with CT scan and MRI) and rehabilitative tool in common practice to assess disability in chronic stroke patient. Keywords: Neuromodulation, Stroke recovery, Transcranial direct current stimulation, Repetitive transcranial magnetic stimulation.
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