Transcranial direct current stimulation and motor function in children with cerebral palsy: A systematic review and meta-analysis

Abstract

Aim: To provide meta-analytical evidence regarding the effects of transcranial direct current stimulation (tDCS) on motor function in children with cerebral palsy (CP) across different stimulation protocols. Method: Using JBI methodology, we applied a random effects model to quantify motor function changes after tDCS. Moderator analyses examined the impact of electrode polarity and stimulation site. Subgroup analyses evaluated the impact of therapy inclusion and the number of sessions. Results: tDCS improved motor function in children with CP (Hedges' g = 0.53; 95% confidence interval [CI] = 0.24–0.81). Moderator analyses revealed statistically significant efficacy of anodal tDCS (Hedges' g = 0.73; 95% CI = 0.45–1.02), especially applied to the primary motor cortex (M1) (Hedges' g = 0.81; 95% CI = 0.52–1.11). Subgroup analyses showed tDCS efficacy with (Hedges' g = 0.86; 95% CI = 0.52–1.20) and without therapy (Hedges' g = 0.70; 95% CI = 0.21–1.19), and in single (Hedges' g = 0.85; 95% CI = 0.39–1.31) and multiple sessions (Hedges' g = 0.78; 95% CI = 0.42–1.14). Limb-specific analysis showed positive effects for lower-limb function (Hedges' g = 0.88; 95% CI = 0.50–1.25). When anodal tDCS was applied to the M1, both lower (Hedges' g = 1.02; 95% CI = 0.70–1.35) and upper (Hedges' g = 0.50; 95% CI = 0.16–0.83) limbs showed improvements. Interpretation: Anodal tDCS, particularly when applied to the M1, may effectively improve motor function in children with CP.