Abstract 30: Transcranial Direct Current Stimulation for Children With Perinatal Stroke and Hemiparesis: a Randomized, Controlled Trial
Bibliographic record
Abstract
Background: Perinatal stroke causes hemiparetic cerebral palsy. Brain stimulation may enhance motor function in adult stroke. We demonstrated that rTMS enhances motor learning therapy in children with perinatal stroke. Transcranial direct current stimulation (tDCS) may have similar capacity but is unstudied. Hypothesis: tDCS increases motor function in hemiparetic children undergoing 2 weeks of motor learning therapy. Methods: Randomized, controlled, double blind clinical trial. Subjects were recruited from a population-based cohort with MRI-classified unilateral perinatal stroke, age 6-18 years, and disabling hemiparesis. All completed a goal-directed, peer-supported, 2 week “after school” motor learning camp (32 hours of therapy). Subjects were randomized 1:1 to 1mA cathodal tDCS over the contralesional primary motor cortex for the initial 20 minutes of daily therapy or sham. Primary subjective (Canadian Occupational Performance Measure, COPM), objective (Assisting Hand Assessment, AHA), safety, and secondary outcomes were measured at 1 week and 2 months. Analysis was intention-to-treat. Results: Twenty-four subjects were randomized (median 11.8+/-2.7 years, range 6.7-17.8). COPM performance and satisfaction scores more than doubled at 1 week with sustained gains at 2 months (p<0.001). Both COPM scores increased more with tDCS compared to sham (p=0.004). AHA scores demonstrated only mild increases at both time points with no tDCS effects. Procedures were safe and well tolerated with no decrease in either arm function or serious adverse events. Conclusion: tDCS trials appear feasible and safe in hemiparetic children. Lack of change in objective motor function may reflect under-dosing of therapy and/or modest sample size. Greater gains in subjective function with tDCS warrant further study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".