Transcranial Direct Current Stimulation Enhances Dual-task Performance in Stroke

Condition(s) studied

Investigational drug(s) / intervention(s)

Active transcranial direct current stimulation: In the active tDCS session, real stimulation was delivered via a current stimulator (DC-STIMULATOR MC, NeuroConn, Germany) using saline-soaked 4×6 cm² electrodes. The anode was positioned over the left-DLPFC identified as F3 according to the 10-20 international EEG system, and the cathode over the right supraorbital ridge.

Sham transcranial direct current stimulation: In the Sham tDCS session, Sham stimulation was delivered via a current stimulator (DC-STIMULATOR MC, NeuroConn, Germany) using saline-soaked 4×6 cm² electrodes. The anode was positioned over the left-DLPFC identified as F3 according to the 10-20 international EEG system, and the cathode over the right supraorbital ridge.

Study summary

Stroke often impairs lower limb control, resulting in gait abnormalities and difficulties in dual-task performance, such as walking while engaging in cognitive activities. This study examines the effects of a single session of transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (DLPFC) on dual-task walking performance in individuals with chronic stroke. Using a cross-over design, participants will undergo two sessions (active or sham tDCS, 7 ± 2 days apart) of stimulation at 2 mA for 30 minutes. Walking performance will be measured using single and dual-task conditions combining motor (e.g., 20 m walk) and cognitive tasks (e.g., word association, random number recall). Primary outcomes include walking speed (m/s), stride length (m), and dual-task cost (DTC) for mobility and cognitive speed.

The study aims to evaluate tDCS as a potential tool to reduce DTC, improve dual-task performance, and improve daily function and quality of life in stroke survivors. Results may guide the development of tailored dual-task interventions in stroke rehabilitation.

Eligibility

Primary outcome measure(s)

• Gait speed — Immediately after the active/sham tDCS intervention
  Kinematic data will be collected using a motion tracking system, the MobilityLab system (APDM Inc., Portland, OR, USA), and the Opal IMU sensor module (with 128 Hz sampling frequency). A total of eight sensors will be attached with Velcro straps to the sternum of the upper body, the lumbar region, and pairs of thighs, lower legs, and feet. The walking speed (m/s) will be recorded during each walking task.
• Stride length — Immediately after the active/sham tDCS intervention
  Kinematic data will be collected using a motion tracking system, the MobilityLab system (APDM Inc., Portland, OR, USA), and the Opal IMU sensor module (with 128 Hz sampling frequency). A total of eight sensors will be affixed using velcro belts, positioned on the sternum of the upper body, at the lumbar region, and on pairs of upper legs, lower legs, and feet. Stride length (m) will be recorded during each walking task.
• Cognitive response rate — Immediately after the active/sham tDCS intervention
  Cognitive performance will be evaluated during each task by the number of correct words per second, defined as the response rate (correct responses/second).
• DTC- Mobility speed — Immediately after the active/sham tDCS intervention
  The impact of dual-tasking will be quantified by calculating the dual-task cost (DTC) using the following formula: DTC (%) = (dual task outcome measure-single task outcome measure)/single task outcome measure × 100. DTC-mobility speed indicates the variation in speed used under dual-task versus single-task conditions.
• DTC- Cognitive speed — Immediately after the active/sham tDCS intervention
  The impact of dual-tasking will be quantified by calculating the dual-task cost (DTC) using the following formula: DTC (%) = (dual task outcome measure-single task outcome measure)/single task outcome measure × 100. For example, DTC-time reflects the variation in time taken to complete the SWR test under dual-task versus single-task conditions. DTC- Cognitive speed represents the variation in response rate under both conditions.

Trial sites (1)

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