Transcranial Direct Current Stimulation Enhances Dual-task Performance in Stroke

NCT06818240 | Recruiting

• 1 other identifier: 2025_DUAL_STROKE
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief 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.

Conditions

Chronic Stroke

Keywords

transcranial direct current stimulation; stroke; dual task

Outcome Measures

Primary Outcomes (5)

• Gait speed

  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.

  Immediately after the active/sham tDCS intervention

• Stride length

  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.

  Immediately after the active/sham tDCS intervention

• Cognitive response rate

  Cognitive performance will be evaluated during each task by the number of correct words per second, defined as the response rate (correct responses/second).

  Immediately after the active/sham tDCS intervention

• DTC- Mobility speed

  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.

  Immediately after the active/sham tDCS intervention

• DTC- Cognitive speed

  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.

  Immediately after the active/sham tDCS intervention

Study Arms (2)

A constant current of 2 mA was applied for 30 minutes

ACTIVE COMPARATOR

In the active tDCS session, a constant current of 2 mA was applied for 30 minutes, with a 30-second ramp-up and ramp-down for comfort.

Device: Active transcranial direct current stimulation

no active current was applied throughout the stimulation phase

SHAM COMPARATOR

For the sham condition, no active current was applied throughout the stimulation phase, except for an electrical current of 1 mA, which was delivered for the first and last 60 seconds, with similar ramping to control for potential sensation bias.

Device: Sham transcranial direct current stimulation

Interventions

Active transcranial direct current stimulation DEVICE

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.

A constant current of 2 mA was applied for 30 minutes

Sham transcranial direct current stimulation DEVICE

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.

no active current was applied throughout the stimulation phase

Eligibility Criteria

• Age: 50 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age between 50 and 80 years
• at least 6 months post-first-ever stroke with unilateral motor deficits
• ability to walk independently for at least 10 m without the use of walking aids
• a score of 24 or higher on the Mini-Mental State Examination (MMSE)

You may not qualify if:

• unstable medical conditions, such as heart failure, uncontrolled hypertension, or cancer
• presence of other comorbidities that could interfere with gait
• history of contraindications to tDCS, such as epilepsy or metal implants
• history of head injury, head surgery, or lower limb orthopedic issues

Sponsors & Collaborators

• The Hong Kong Polytechnic University: lead

Study Sites (1)

The Hong Kong Polytechnic University

Hong Kong, China, Hong Kong

RECRUITING

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Shamay SM NG, PhD

  The Hong Kong Polytechnic University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Shamay SM NG, PhD

CONTACT

+85227664889; shamay.ng@polyu.edu.hk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof.

Study Record Dates

• First Submitted: January 23, 2025
• First Posted: February 10, 2025
• Study Start: November 1, 2024
• Primary Completion: February 28, 2025
• Study Completion: February 28, 2025
• Last Updated: February 10, 2025

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

HK (1)