The Effect of tDCS Combined With Functional Task Training on Motor Recovery in Stroke Patients

Inclusion Criteria: 1. age 18-90 2. first-time clinical ischemic or hemorrhagic cerebrovascular accident as noted in the radiological (or physician's) report; 3. the ability to extend =20° at the wrist and 10° at the metacarpophalangeal and interphalangeal joints of all digits; 4. participants must demonstrate adequate balance while wearing the restraint; 5. the ability to stand from a sitting position and the ability to stand for at least 2 minutes with or without upper extremity support; 6. weakness, defined as score of 15-55 (out of 66) on arm motor Fugl-Meyer (FM) scale; and 7. stroke onset more then 6 months prior to study enrollment. Exclusion Criteria: 1. significant pre-stroke disability; 2. where applicable (a history of depression before the stroke); 3. any substantial decrease in alertness, language reception, or attention that might interfere with understanding the instructions for the motor testing; 4. excessive pain in any joint of the paretic extremity; 5. contraindications to single-pulse TMS (TMS will be used to measure cortical excitability) such as metal head implants; 6. advanced liver, kidney, cardiac, or pulmonary disease; 7. a terminal medical diagnosis consistent with survival 1 year; 8. coexistent major neurological or psychiatric disease (to decrease the number of confounders); 9. a history of significant drug abuse in the prior 6 months; 10. the use of certain neuropsychotropic drugs such as tricyclics, antidepressants, or 51 of 66 carbamazepine; 11. active enrollment in a separate intervention study targeting stroke recovery; ( 12. previously applied constraint-induced motor therapy and/or tDCS treatment for stroke; and 13. a history of epilepsy before stroke (or episodes of seizures within the last six months).