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Targeting motor and cognitive networks with multichannel transcranial direct current stimulation along with peripheral stimulation in a subacute stroke survivor: single case study
Physical Therapy Rehabilitation Science 2020;9:318-23
Published online December 30, 2020
© 2020 Korean Academy of Physical Therapy Rehabilitation Science.

Divya Midha , Narkeesh Arumugam

Department of Physiotherapy, Punjabi University, Patiala, India
Correspondence to: Divya Midha (ORCID
Department of Physiotherapy, Punjabi University, NH 64, Urban Estate Phase II, Patiala 147002, India
Tel: 91-8607556615 E-mail:
Received September 1, 2020; Revised November 1, 2020; Accepted November 18, 2020.
cc This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor.
Design: A case report.
Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention.
Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks.
Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.
Keywords : Brain stimulation, Multichannel transcranial direct current stimulation, Stroke


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Funding Information
  • Department of Physiotherapy, Punjabi University for resource allocation and participant recruitment
  • Medicaid India
  • Authorship and ethical issues