{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:25:34Z","timestamp":1788967534205,"version":"build-2803163510"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,10]]},"abstract":"\n Background:<\/jats:title>\n Transcranial direct current stimulation (tDCS) is a promising tool for improving poststroke cognitive function. Home-based rehabilitation is increasingly required for patients with stroke, and additional benefits are expected if supplemented with remotely supervised tDCS (RS-tDCS). We evaluated the cognitive improvement effect and feasibility of RS-tDCS in patients with chronic stroke.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Twenty-six patients with chronic stroke and cognitive impairment (Korean version of the Montreal Cognitive Assessment [K-MoCA] score <26) were randomized into real and sham RS-tDCS groups and underwent concurrent computerized cognitive training and RS-tDCS. Patients and caregivers underwent training to ensure correct tDCS self-application, were monitored, and treated 5 d\/wk for 4 weeks. We investigated several cognition tests including K-MoCA, Korean version of the Dementia Rating Scale-2, Korean-Boston Naming Test, Trail Making Test, Go\/No Go, and Controlled Oral Word Association Test at the end of the training sessions and one month later. Repeated-measures ANOVA was used for comparison between the groups and within each group. The adherence rate of the appropriate RS-tDCS session was also investigated.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n In within-group comparison, unlike the sham group, the real group showed significant improvement in K-MoCA (\n P<\/jats:italic>\n real<\/jats:sub>\n =0.004 versus\n P<\/jats:italic>\n sham<\/jats:sub>\n =0.132), particularly in patients with lower baseline K-MoCA (K-MoCA\n 10\u201317<\/jats:sub>\n ;\n P<\/jats:italic>\n real<\/jats:sub>\n =0.001 versus\n P<\/jats:italic>\n sham<\/jats:sub>\n =0.835, K-MoCA\n 18\u201325<\/jats:sub>\n ;\n P<\/jats:italic>\n real<\/jats:sub>\n =0.060 versus\n P<\/jats:italic>\n sham<\/jats:sub>\n =0.064) or with left hemispheric lesions (left;\n P<\/jats:italic>\n real<\/jats:sub>\n =0.010 versus\n P<\/jats:italic>\n sham<\/jats:sub>\n =0.454, right;\n P<\/jats:italic>\n real<\/jats:sub>\n =0.106 versus\n P<\/jats:italic>\n sham<\/jats:sub>\n =0.128). In between-group comparison, a significant difference was observed in K-MoCA in the lower baseline K-MoCA subgroup (K-MoCA\n 10\u201317<\/jats:sub>\n ;\n P<\/jats:italic>\n time\u00d7group<\/jats:sub>\n =0.048), but no significant difference was found in other cognitive tests. The adherence rate of successful application of the RS-tDCS was 98.4%, and no serious adverse effects were detected.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n RS-tDCS is a safe and feasible rehabilitation modality for poststroke cognitive dysfunction. Specifically, RS-tDCS is effective in patients with moderate cognitive decline. Additionally, these data demonstrate the potential to enhance home-based cognitive training, although significant differences were not consistently found in between-group comparisons; therefore, further larger studies are needed.<\/jats:p>\n <\/jats:sec>\n \n Registration:<\/jats:title>\n \n URL:\n https:\/\/cris.nih.go.kr<\/jats:ext-link>\n ; Unique identifier: KCT0003427.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/strokeaha.121.037629","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T05:00:41Z","timestamp":1660712441000},"page":"2992-3001","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":51,"title":["Home-Based Transcranial Direct Current Stimulation to Enhance Cognition in Stroke: Randomized Controlled Trial"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0566-3677","authenticated-orcid":true,"given":"Myoung-Hwan","family":"Ko","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)."},{"name":"Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)."},{"name":"Translational Research & Clinical Trials Center for Medical Devices, Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., G.-W.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2379-6158","authenticated-orcid":true,"given":"Ju-Yul","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)."},{"name":"Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1307-8371","authenticated-orcid":true,"given":"Yun-Ju","family":"Jo","sequence":"additional","affiliation":[{"name":"Translational Research & Clinical Trials Center for Medical Devices, Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., G.-W.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4442-5989","authenticated-orcid":true,"given":"Mi-Nam","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (M.-N.S., Y.-H.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da-Sol","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)."},{"name":"Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., 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