---
title: "tDCS montages produce distinct lateralization effects that improve motor function after chronic st"
id: "pubmed-42607705"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42607705"
content_type: "clinical_feed_article"
specialty: "Neurology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42607705/"
doi: "10.1088/1741-2552/ae9aca"
published_at: "2026-08-28T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# tDCS montages produce distinct lateralization effects that improve motor function after chronic st
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42607705
- **Specialty:** [Neurology](https://medichelpline.com/clinical-feed/neurology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42607705/)
- **DOI:** [10.1088/1741-2552/ae9aca](https://doi.org/10.1088%2F1741-2552%2Fae9aca)
- **Published At:** 2026-08-28T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This randomized, single-blind crossover trial enrolled 28 patients with chronic subcortical stroke to compare four transcranial direct current stimulation (**tDCS**) montages: **anodal tDCS**, **cathodal tDCS**, **bilateral tDCS**, and sham. - Resting-state electroencephalography (**EEG**) was recorded immediately before and after each intervention to capture acute changes in dynamic functional connectivity (dFC). - An asymmetry index matrix derived from mutual information–based dFC quantified lateralization of motor networks; robust feature selection isolated key connectivity features that discriminated pre- versus post-intervention states. - Network-dynamics features classified stimulation state with high accuracy (AUC range 0.87–0.98), indicating clear, montage-specific effects on network organization. - **Anodal tDCS** uniquely reversed contralesional network dominance, promoting ipsilesional connectivity and shifting interhemispheric balance toward the affected hemisphere. - **Cathodal** and **bilateral tDCS** primarily produced contralesional network inhibition rather than direct ipsilesional facilitation; sham showed no directional bias. - A specific contralesional connection (P2–P6) showed functional inhibition under bilateral tDCS that significantly correlated with acute motor improvement on the **Jebsen-Taylor Hand Function Test (JTT)** (r = 0.55, p = 0.04). - The findings suggest distinct mechanistic pathways: anodal stimulation drives ipsilesional facilitation, while cathodal and bilateral approaches act mainly via contralesional inhibition, offering mechanistic insight into tailoring tDCS montages for post-stroke motor rehabilitation.
## Clinical Analysis & Structured Key Points
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more resources Randomized Controlled Trial J Neural Eng Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Neural+Eng%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Neural+Eng%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607705/) . 2026 Aug 28;23(4). doi: 10.1088/1741-2552/ae9aca. # Distinct tDCS montages act via dissociable lateralization mechanisms to enhance motor function in chronic stroke [Yaqian Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+Y&cauthor_id=42607705)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-1 "College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-2 "Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-3 "Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China."), [Ying Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+Y&cauthor_id=42607705)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-4 "Department of Rehabilitation Medicine Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Nankai University, Tianjin 300121, People's Republic of China.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-5 "Tianjin Institute of Rehabilitation, Tianjin 300121, People's Republic of China."), [Shupei Jiao](https://pubmed.ncbi.nlm.nih.gov/?term=Jiao+S&cauthor_id=42607705)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-1 "College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-2 "Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-3 "Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China."), [Jiewei Lu](https://pubmed.ncbi.nlm.nih.gov/?term=Lu+J&cauthor_id=42607705)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-1 "College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-2 "Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-3 "Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China."), [Chunfang Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+C&cauthor_id=42607705)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-4 "Department of Rehabilitation Medicine Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Nankai University, Tianjin 300121, People's Republic of China.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-5 "Tianjin Institute of Rehabilitation, Tianjin 300121, People's Republic of China."), [Ningbo Yu](https://pubmed.ncbi.nlm.nih.gov/?term=Yu+N&cauthor_id=42607705)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-1 "College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-2 "Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#full-view-affiliation-3 "Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China.") Affiliations Expand ### Affiliations * 1 College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China. * 2 Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China. * 3 Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China. * 4 Department of Rehabilitation Medicine Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Nankai University, Tianjin 300121, People's Republic of China. * 5 Tianjin Institute of Rehabilitation, Tianjin 300121, People's Republic of China. * PMID: **42607705** * DOI: [ 10.1088/1741-2552/ae9aca ](https://doi.org/10.1088/1741-2552/ae9aca) Item in Clipboard Randomized Controlled Trial # Distinct tDCS montages act via dissociable lateralization mechanisms to enhance motor function in chronic stroke Yaqian Li et al. J Neural Eng. 2026. Show details Display options Display options Format Abstract PubMed PMID J Neural Eng Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Neural+Eng%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Neural+Eng%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607705/) . 2026 Aug 28;23(4). doi: 10.1088/1741-2552/ae9aca. ### Authors [Yaqian Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+Y&cauthor_id=42607705)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-1 "College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-2 "Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-3 "Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China."), [Ying Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+Y&cauthor_id=42607705)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-4 "Department of Rehabilitation Medicine Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Nankai University, Tianjin 300121, People's Republic of China.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-5 "Tianjin Institute of Rehabilitation, Tianjin 300121, People's Republic of China."), [Shupei Jiao](https://pubmed.ncbi.nlm.nih.gov/?term=Jiao+S&cauthor_id=42607705)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-1 "College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-2 "Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-3 "Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China."), [Jiewei Lu](https://pubmed.ncbi.nlm.nih.gov/?term=Lu+J&cauthor_id=42607705)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-1 "College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-2 "Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-3 "Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China."), [Chunfang Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+C&cauthor_id=42607705)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-4 "Department of Rehabilitation Medicine Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Nankai University, Tianjin 300121, People's Republic of China.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-5 "Tianjin Institute of Rehabilitation, Tianjin 300121, People's Republic of China."), [Ningbo Yu](https://pubmed.ncbi.nlm.nih.gov/?term=Yu+N&cauthor_id=42607705)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-1 "College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-2 "Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42607705/#short-view-affiliation-3 "Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China.") ### Affiliations * 1 College of Artificial Intelligence, Nankai University, Tianjin, People's Republic of China. * 2 Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, People's Republic of China. * 3 Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education Nankai University, Tianjin, People's Republic of China. * 4 Department of Rehabilitation Medicine Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Nankai University, Tianjin 300121, People's Republic of China. * 5 Tianjin Institute of Rehabilitation, Tianjin 300121, People's Republic of China. * PMID: **42607705** * DOI: [ 10.1088/1741-2552/ae9aca ](https://doi.org/10.1088/1741-2552/ae9aca) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract _Objective_. The imbalance in interhemispheric functional connectivity following stroke fundamentally impedes motor recovery. Although transcranial direct current stimulation (tDCS) effectively modulates neuroplasticity, the acute effects of distinct stimulation montages on lateralized brain networks and how these network shifts drive behavioral improvements warrant further investigation._Approach_. We employed a single-blind, randomized crossover design involving 28 patients with chronic subcortical stroke. Participants received anodal, cathodal, bilateral, or sham tDCS targeting the primary motor cortex. Resting-state electroencephalography data were acquired immediately before and after each intervention. To quantify network lateralization, we computed dynamic functional connectivity (dFC) using mutual information and constructed an asymmetry index matrix. Key connectivity features were isolated via robust feature selection algorithms, classifying stimulation states and evaluating correlations with acute motor gains on the Jebsen-Taylor Hand Function Test (JTT)._Main results_. Network dynamics features successfully discriminated pre- versus post-intervention states with high accuracy (AUC: 0.87-0.98). All three active tDCS protocols exhibited montage-specific directional modulation. Crucially, anodal tDCS uniquely reversed contralesional network dominance, facilitating ipsilesional connectivity and shifting the interhemispheric balance toward the affected hemisphere. Conversely, cathodal and bilateral tDCS predominantly induced contralesional network inhibition, whereas sham stimulation exhibited no directional bias. Furthermore, the functional inhibition of the contralesional network (specifically at the P2-P6 connection) induced by bilateral tDCS significantly correlated with acute JTT improvements (_r_ = 0.55,_p_ = 0.04)._Significance_. This study demonstrates that distinct tDCS montages modulate stroke-induced network imbalances through dissociable lateralization mechanisms. While anodal tDCS drives ipsilesional facilitation to reverse contralesional dominance, bilateral and cathodal montages operate primarily via contralesional inhibition. These findings provide critical mechanistic insights into interhemispheric network dynamics. **Keywords:** brain asymmetry; electroencephalography (EEG); machine learning; stroke; transcranial direct current stimulation (tDCS). © 2026 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Neuroplasticity and network connectivity of the motor cortex following stroke: A transcranial direct current stimulation study. ](https://pubmed.ncbi.nlm.nih.gov/29655257/) Hordacre B, Moezzi B, Ridding MC.Hordacre B, et al.Hum Brain Mapp. 2018 Aug;39(8):3326-3339. doi: 10.1002/hbm.24079. Epub 2018 Apr 14.Hum Brain Mapp. 2018.PMID: 29655257Free PMC article.Clinical Trial. * [ The effects of combined repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function in patients with stroke. ](https://pubmed.ncbi.nlm.nih.gov/27689549/) Kwon TG, Park E, Kang C, Chang WH, Kim YH.Kwon TG, et al.Restor Neurol Neurosci. 2016 Nov 22;34(6):915-923. doi: 10.3233/RNN-160654.Restor Neurol Neurosci. 2016.PMID: 27689549Clinical Trial. * [ Contralesional Cathodal versus Dual Transcranial Direct Current Stimulation for Decreasing Upper Limb Spasticity in Chronic Stroke Individuals: A Clinical and Neurophysiological Study.
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