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The potential of transcranial direct current stimulation to facilitate motor learning in children and young people with hemiplegic cerebral palsy

Transcranial direct current stimulation (tDCS) is a non-invasive stimulation technique that modulates brain function by increasing or decreasing cortical excitability (Nitsche & Paulus, 2001). In chronic stroke patients tDCS has been shown to improve function of the affected arm when combined with rehabilitative motor training (e.g. Lindenberg et al., 2010) and thus has the potential to accelerate motor learning. Its potential as a treatment for upper limb function in hemiplegic cerebral palsy (CP) had not been explored, which was the principle aim of this doctorate. After literature reviews on CP and tDCS (Chapter 1) feasibility work in healthy subjects was conducted to develop and validate the experimental procedures (Chapters 2 to 5). Chapter 2 examined whether tDCS improved motor performance of the non-preferred hand in healthy right-handed adults. The sophisticated kinematic outcome measures detected changes in performance due to learning, but no effect of tDCS was found. In Chapter 3, a novel motor learning task was developed and validated in healthy children and adolescents. This task was added to the study protocol and using a revised study design tDCS was found again to have no benefit on either motor performance or motor learning in healthy adults (Chapter 4). Tolerability, perception and acceptance of electrical stimulation were explored in Chapters 5 and 6, with the former showing that tDCS was well tolerated by healthy adults. Using a qualitative research methodology Chapter 6 established that teenagers with CP and their parents had concerns over the application of electricity on the scalp and how little is currently known of tDCS effects in CP. In Chapter 7, tDCS was applied to a teenager with hemiplegic CP with no clear beneficial effects. Finally, the contribution of this doctoral work with regard to the use of tDCS for the rehabilitation of motor function in CP is discussed in Chapter 8.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:582720
Date January 2013
CreatorsScheffler, Grit
PublisherUniversity of Aberdeen
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Sourcehttp://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=201982

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