Characterized by high morbidity, mortality, and disability, stroke usually causes symptoms of cerebral hypoxia due to a sudden blockage or rupture of brain vessels, and it seriously threatens human life and health. Rehabilitation is the essential treatment for post-stroke patients suffering from functional impairments, through which hemiparesis, aphasia, dysphagia, unilateral neglect, depression, and cognitive dysfunction can be restored to various degrees. Noninvasive brain stimulation (NIBS) is a popular neuromodulatory technology of rehabilitation focusing on the local cerebral cortex, which can improve clinical functions by regulating the excitability of corresponding neurons. Increasing evidence has been obtained from the clinical application of NIBS, especially repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). However, without a standardized protocol, existing studies on NIBS show a wide variation in terms of stimulation site, frequency, intensity, dosage, and other parameters. Its application for neurorehabilitation in post-stroke patients is still limited. With advances in neuronavigation technologies, functional near-infrared spectroscopy, and functional MRI, specific brain regions can be precisely located for stimulation. On the basis of our further understanding on neural circuits, neuromodulation in post-stroke rehabilitation has also evolved from single-target stimulation to co-stimulation of two or more targets, even circuits and the network. The present study aims to review the findings of current research, discuss future directions of NIBS application, and finally promote the use of NIBS in post-stroke rehabilitation.

BackgroundThe associations of ambient air pollution with hospital admissions (HAs) for overall and specific causes of cardiovascular diseases (CVDs), as well as related morbidity and economic burdens remain understudied, especially in low-pollution areas of low-and middle-income countries (LMICs). We evaluated the short-term effects of exposure to PM 2.5 (particles with an aerodynamic diameter ≤2.5 μm), PM 10 (particles with an aerodynamic diameter ≤10 μm), and SO 2 (sulfur dioxide) on HAs for CVDs in Panzhihua, China, during 2016-2020, and calculated corresponding attributable risks and economic burden. MethodsWe used a generalized additive model (GAM) while controlling for time trends, meteorological conditions, holidays, and days of the week to estimate the associations. The cost of illness (COI) method was adopted to further assess corresponding hospitalization costs and productivity losses.Results A total of 27 660 HAs for CVDs were included in this study. PM 10 and SO 2 were significantly associated with elevated risks of CVDs hospitalizations. Each 10 μg/m 3 increase in PM 10 and SO 2 at lag06 corresponded to an increase of 2.48% (95% confidence interval (CI) = 0.92%-4.06%), and 5.50% (95% CI = 3.09%-7.97%) in risk of HAs for CVDs, respectively. The risk estimates of PM 10 and SO 2 on CVD hospitalizations were generally robust after adjustment for other pollutants in two-pollutant models. We found stronger associations between air pollution (PM 10 and SO 2 ) and CVDs in cool seasons than in warm seasons. For specific causes of CVDs, significant associations of PM 10 and SO 2 exposure with cerebrovascular disease and ischaemic heart disease were observed. Using 0 μg/m 3 as the reference concentrations, 11.91% (95%CI = 4.64%-18.56%) and 15.71% (95%CI = 9.30%-21.60%) of HAs for CVDs could be attributable to PM 10 and SO 2 , respectively. During the study period, PM 10 and SO 2 brought 144.34 million Yuan economic losses for overall CVDs, accounting for 0.028% of local GDP. ConclusionsOur results suggest that PM 10 and SO 2 exposure might be an important trigger of HAs for CVDs and accounted for substantial morbidity and economic burden.