2026 SICOT Annual Meeting: Modulating cortical excitability restores hand dexterity in cervical spondylotic myelopathy: A randomized sham-controlled crossover trial

14 patients with cervical spondylotic myelopathy (CSM) underwent randomized sessions of anodal, cathodal, and sham transcranial direct current stimulation (tDCS) targeting the left primary motor cortex (M1) in a double-blind crossover trial. The primary outcome of interest was hand dexterity assessed using the grip-and-release test. Secondary outcomes included finger-tapping speed and grip and pinch strength. Outcomes were assessed at baseline and at multiple time points up to 50 minutes after stimulation. Overall, the results revealed that anodal M1-tDCS significantly improved grip-and-release performance and finger-tapping speed compared with sham, while cathodal stimulation produced no significant benefit. These findings suggest that increasing M1 excitability may transiently improve hand motor function in patients with CSM.