TY - JOUR
T1 - New modalities of brain stimulation for stroke rehabilitation
AU - Edwardson, M. A.
AU - Lucas, T. H.
AU - Carey, J. R.
AU - Fetz, E. E.
PY - 2013/2
Y1 - 2013/2
N2 - 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.
AB - 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.
KW - Activity-dependent
KW - Epidural cortical stimulation
KW - Motor cortex
KW - Stroke rehabilitation
KW - Transcranial direct current stimulation
KW - Transcranial magnetic stimulation
UR - http://www.scopus.com/inward/record.url?scp=84873735203&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873735203&partnerID=8YFLogxK
U2 - 10.1007/s00221-012-3315-1
DO - 10.1007/s00221-012-3315-1
M3 - Article
C2 - 23192336
AN - SCOPUS:84873735203
SN - 0014-4819
VL - 224
SP - 335
EP - 358
JO - Experimental Brain Research
JF - Experimental Brain Research
IS - 3
ER -