Exploring sex-dependent responses to anodal tDCS in subacute stroke rehabilitation: a post-hoc analysis of the randomized sham-controlled NETS Trial

In the NETS randomized trial of 119 patients with subacute ischemic stroke, women receiving 1 mA anodal tDCS improved Upper-Extremity Fugl-Meyer Assessment by 6.0 points versus sham over 90 days.

• Why it matters: Large randomized tDCS trials have shown inconsistent benefits, and sex differences in anatomy and neurophysiology may help explain variability in upper-limb recovery responses.
• What they did: NETS assigned patients to anodal tDCS over the ipsilesional primary motor cortex or sham alongside standardized rehabilitation, then used longitudinal mixed-effects models to test treatment-by-sex interactions across 90-day follow-up.
• The result: Treatment-by-sex interactions were also seen for Box-and-Block Test (8.4 points; 95%-CI 2.4;14.3) but not for Stroke Impact Scale participation, suggesting sex may modify response in body function and activity.

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