New modalities of brain stimulation for stroke rehabilitation

Springer Science and Business Media LLC - Tập 224 - Trang 335-358 - 2012
M. A. Edwardson1, T. H. Lucas2, J. R. Carey3, E. E. Fetz4
1NINDS Stroke Branch, National Institutes of Health, Bethesda, USA
2Department of Neurosurgery, University of Pennsylvania, Philadelphia, USA
3Program in Physical Therapy, University of Minnesota, Minneapolis, USA
4Department of Physiology and Biophysics, University of Washington, Seattle, USA

Tóm tắt

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.

Tài liệu tham khảo

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