New modalities of brain stimulation for stroke rehabilitation

M. A. Edwardson, T. H. Lucas, J. R. Carey, E. E. Fetz

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

Stroke is a leading cause of disability, and the number of stroke survivors continues to rise. Traditional neurorehabilitation strategies aimed at restoring function to weakened limbs provide only modest benefit. New brain stimulation techniques designed to augment traditional neurorehabilitation hold promise for reducing the burden of stroke-related disability. Investigators discovered that repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and epidural cortical stimulation (ECS) can enhance neural plasticity in the motor cortex post-stroke. Improved outcomes may be obtained with activity-dependent stimulation, in which brain stimulation is contingent on neural or muscular activity during normal behavior. We review the evidence for improved motor function in stroke patients treated with rTMS, tDCS, and ECS and discuss the mediating physiological mechanisms. We compare these techniques to activity-dependent stimulation, discuss the advantages of this newer strategy for stroke rehabilitation, and suggest future applications for activity-dependent brain stimulation.

Original languageEnglish (US)
Pages (from-to)335-358
Number of pages24
JournalExperimental Brain Research
Volume224
Issue number3
DOIs
StatePublished - Feb 2013

Keywords

  • Activity-dependent
  • Epidural cortical stimulation
  • Motor cortex
  • Stroke rehabilitation
  • Transcranial direct current stimulation
  • Transcranial magnetic stimulation

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