Neurophysiological and Behavioral Effects of Combining Transcranial Direct Current Stimulation (tDCS) and Modified-Constraint Induced Movement Therapy (mCIMT)

Inclusion Criteria: 1. Adult participants clinically diagnosed and confirmed by imaging of ischemic or hemorrhagic cerebrovascular accident (Dahl et al., 2008; Jin et al., 2019). 2. Participant's age older than 18 years (Baltar et al., 2020). 3. Stroke onset more than 3 months with unilateral motor deficits (Lin et al., 2010). 4. Adequate cognitive function is required to follow instructions. The Arabic version of the Mini Mental State Examination (MMSE) should be ≥24 (Kim, 2021). 5. 10° of active extension to the metacarpophalangeal and interphalangeal joints and 20° at wrist will be assessed by manual goniometer (Dahl et al., 2008). 6. Fugl-Meyer assessment (FMA) scores between 19 and 58, indicating moderate to mild impairments. 7. Not participating in other clinical, or research studies at the same time. Exclusion Criteria: 1. Severe muscle spasticity at the affected limb at all joints (the Modified Ashworth Scale scores \> 3) (Baltar et al., 2020). 2. Contraindications to NIBS (Bornheim et al., 2019). 3. Unilateral neglect (Dahl et al., 2008) 4. Other neurologic or orthopedic conditions that may affect hand function. 5. Unstable medical conditions.