A protocol to optimize non-invasive brain stimulation for post-stroke rehabilitation

This randomized controlled trial investigates the optimal dosing for post-stroke rehabilitation using repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimu- lation (tDCS). Previous studies demonstrated improvements in cognitive and motor functions with specific intensities of rTMS and tDCS, but this trial explores various frequencies and currents to optimize therapeutic outcomes. A total of 128 post-stroke patients (within 1-6 months of stroke) with paraplegia or hemiplegia are recruited. Patients are divided into four groups for both rTMS (n = 49) and tDCS (n = 49): three groups with different stimulation intensities (1 Hz, 5 Hz, 10 Hz for rTMS; 0.5 mA, 1 mA, 2 mA for tDCS) and a sham control group. Along with this, there is a standard therapy group (n = 30) as control. Participants receive 20 min sessions, five days a week, over six weeks. Cognitive and motor assessments are conducted at 4 weeks, 6 weeks, and 6 months to measure short-term and sustained effects. center dot Hemodynamically stable post-stroke patients randomized in four groups in rTMS and tDCS each and their baseline cognitive and motor function assessed center dot Application of the two types of therapy for 6 weeks center dot Checking improvement of cognitive and motor function and compare the improvement among subgroups of recipient of various frequencies and currents.