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Turki Abualat

Imam Abdulrahman bin Faisal University, Dammam, SA

Title: Structural Neuroplastic Change nd Behavioral Motor Recovery after transcranial Direct Current Stimulation (tDCS) in Patient with Stroke: A Case Study

Biography

Biography: Turki Abualat

Abstract

Fine motor and manual dexterity  deficits are  the main  cause of  functional  disability  that  leave  stroke  survivors  with  significant  impairment  physically  and  psychosocially.  transcranial  direct  current  stimulation  (tDCS)  is  one  of  the  non-invasive  brain  stimulation  (NIBS)  novel  techniques  that  can  be  used  in  modulating  brain  activity  and  improving  functional  and  clinical  outcomes.  To  investigate  the  therapeutic  utility  of  applying  tDCS  in behavioral  functions in patients  with stroke, a 48-year- old,  left-handed  male  who  had  a  right-hemisphere-fronto- parietal  ischemic  stroke  suffering  from  cortical  sensation  deficits; asterognosis and agraphesthesia was participated in  30  sessions of sham tDCS  before crossover  to  30  sessions of  dual- hemispheric tDCS in a double-blind, sham-controlled single-case  study. Six weeks of daily sessions (5 days per week) with (2 mA,  20  min).  Direct  current  was  delivered  from  a  battery-driven,  constant  current  stimulator  (Magstim HDCStim stimulator,  The  Magstim Co., Whitland, UK) using saline-soaked surface sponge  electrodes (5 × 5 cm)  with anodal  tDCS placed  over ipsilesional  primary motor area (M1), and cathodal over contralesional M1. Functional  outcome  measures  were  assessed  with  grooved  pegboard,  box  and  block  test  (BBT),  action  research  arm  test  (ARAT), functional  dexterity  test  (FDT)  and  nine-hole  peg  test (NHPT),  in  several  times;  prior  stimulation  (T0),  immediately  post (T1), as well as 1 month (T3) and 3 months after the end of  procedure  (T4). Structural  and  tensor  diffusion  imaging  (DTI)  data  were  also  acquired  prior  (T0)  and  after  stimulation  (T1).  Slight  improvement  in  grooved  pegboard,  (BBT),  (ARAT),  (FDT)  and  (NHPT)  in  sham  was  noticed  in  (T1).  However,  with  real  dual-hemispheric  stimulation  all  findings  were  clinically  significant  across  all  times  (T1,  T3  and  T4).  Higher  fractional  anisotropy  (FA)  and  lower  diffusivity  of  the  corticospinal  tract  (CST)  positively  correlated  with  better  recovery  of  fine  motor  and  manual  dexterity.  tDCS  intervention  induces  not  only  behavioral but also and structural changes  in stroke.