{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:41:40Z","timestamp":1788964900107,"version":"build-2803163510"},"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["52375224"],"award-info":[{"award-number":["52375224"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Xuzhou National Clinical Key Specialist Training Project","award":["2018KZ002"],"award-info":[{"award-number":["2018KZ002"]}]},{"name":"Xuzhou Medical Key Talent Project","award":["XWRCHT20220045"],"award-info":[{"award-number":["XWRCHT20220045"]}]},{"name":"Postgraduate Research & Practice Innovation Program of Jiangsu Province","award":["KYCX24-3063"],"award-info":[{"award-number":["KYCX24-3063"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec040\">\n<jats:title>Background<\/jats:title>\n<jats:p>Occupational therapy (OT) and transcranial direct current stimulation (tDCS) are both important methods for promoting the recovery after stroke. There are limited researches that simultaneously apply both methods and investigate their effects on upper limb function.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec041\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To investigate the effects of OT synchronized with dual tDCS on upper limb motor function and Electroencephalogram (EEG) power in subacute stroke patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec042\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Forty-five subacute stroke patients were randomly assigned to control group (n\u2009=\u200923) and experimental group (n\u2009=\u200922), receiving sham and real dual tDCS concurrent with OT respectively, five times a week, for a duration of two weeks. Upper limb motor function and cortical EEG power were evaluated by Fugl-Meyer Assessment Upper Extremity (FMA-UE), Modified Barthel Index (MBI) and Action Research Arm Test (ARAT), Delta\/Alpha Ratio (DAR) and pairwise derived Brain Symmetry Index (pdBSI) at baseline and two weeks.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec043\">\n<jats:title>Results<\/jats:title>\n<jats:p>Finally, a total of 39 patients completed the study and were included in the analysis. The results revealed that participants in the experimental group showed a significant better evolution for FMA-UE (p\u2009&lt; 0.001), MBI (p\u2009= 0.034), DAR in the primary motor cortex (M1) area (p\u2009= 0.022) and pdBSI (p\u2009= 0.025) compared to the control group.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec044\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In subacute stroke patients, the central-peripheral combined stimulation approach, which involves dual tDCS (central stimulation) and synchronous OT (peripheral sensory-motor stimulation) enhanced the effects of OT alone, leading to greater improvements in upper limb function and normalization of brain activity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec045\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>This trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2400082749).<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0320142","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T17:41:20Z","timestamp":1742319680000},"page":"e0320142","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effects of occupational therapy synchronized with dual transcranial direct current stimulation on upper limb function and electroencephalography power in subacute stroke patients: A randomized, double-blind, controlled 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