The Effects of Transcranial Direct Current Stimulation on Acute Ischemic Stroke—A Randomized, Double-blind, Sham-Controlled Study

Objectives: Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique that has shown potential in enhancing motor recovery and cognitive function in chronic stroke patients. However, the application of tDCS in the acute setting of ischemic stroke remains largely unexplored. Methods: This randomized, double-blind, sham-controlled study enrolled 60 acute ischemic stroke patients within 2 days of onset. Participants were randomly assigned to receive either real tDCS or sham stimulation for 5 sessions over 7 days. The primary outcomes were changes in the Fugl-Meyer (FM) motor scale, National Institutes of Health Stroke Scale (NIHSS) scores, incidence of early neurological deterioration, and favorable functional outcome (modified Rankin Scale ≤2) at 3 months poststroke. Results: Early neurological deterioration occurred in 6.7% of the tDCS group and 26.7% of the sham group, but this difference did not reach statistical significance ( P =0.065). No significant differences were observed between the tDCS and sham groups in terms of FM scores, NIHSS scores, or favorable functional outcomes at 3 months. No significant group-by-time interactions were found for FM scores ( P =0.481) or NIHSS scores ( P =0.157). Conclusions: This study demonstrates that tDCS can be safely administered in the acute phase of ischemic stroke. While no significant effects on motor function or neurological outcomes were observed compared with sham stimulation, the trend toward reduced early neurological deterioration warrants further investigation.