A translational roadmap for transcranial magnetic and direct current stimulation in stroke rehabilitation: Consensus-based core recommendations from the third stroke recovery and rehabilitation roundtable

Abstract

Background and Aims: The purpose of this Third Stroke Recovery and Rehabilitation Roundtable (SRRR3) was to develop consensus recommendations to address outstanding barriers for the translation of preclinical and clinical research using the non-invasive brain stimulation (NIBS) techniques Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) and provide a roadmap for the integration of these techniques into clinical practice. Methods: International NIBS and stroke recovery experts (N = 18) contributed to the consensus process. Using a nominal group technique, recommendations were reached via a five-stage process, involving a thematic survey, two priority ranking surveys, a literature review and an in-person meeting. Results and Conclusions: Results of our consensus process yielded five key evidence-based and feasibility barriers for the translation of preclinical and clinical NIBS research, which were formulated into five core consensus recommendations. Recommendations highlight an urgent need for (1) increased understanding of NIBS mechanisms, (2) improved methodological rigor in both preclinical and clinical NIBS studies, (3) standardization of outcome measures, (4) increased clinical relevance in preclinical animal models, and (5) greater optimization and individualization of NIBS protocols. To facilitate the implementation of these recommendations, the expert panel developed a new SRRR3 Unified NIBS Research Checklist. These recommendations represent a translational pathway for the use of NIBS in stroke rehabilitation research and practice.

The Effectiveness of Paired Associative Stimulation on Motor Recovery after Stroke: A Scoping Review

“…This lack may be due to their relatively recent introduction in the clinical setting, which makes further studies necessary to evaluate the applicability of this technique for patient recovery [ 45 ]. Moreover, the technologies required to implement PAS into practice are extremely expensive and require specific skills not always available outside the research settings [ 46 ]. However, considering their potential from a neurorehabilitation perspective, here, to the best of our knowledge, we have gathered evidence on PAS-empowered post-stroke motor rehabilitation.…”

What’s on the recovery and rehabilitation horizon? The third international Stroke Recovery and Rehabilitation Roundtable (SRRR3) initiative

“…6 The second addressed consensus concerning trial development, 7 cognition, 8 translation into clinical practice, 9 and standardized measurement of quality of movement. 10 The third roundtable focused on control comparator trial design, 11 fatigue, 12 non-invasive brain stimulation, 13 and standardized measurement of balance and mobility. 14 A global initiative and undertaking, SRRR3 included over 50 experts from more than 20 countries around the world.…”

“…Another taskforce was established to develop consensus recommendations to identify and address outstanding translational bench-bedside barriers and provide a roadmap for the use of transcranial magnetic stimulation and transcranial Direct Current Stimulation for stroke recovery and rehabilitation. 13 Recommendations highlight an urgent need for an increased understanding of non-invasive brain stimulation mechanisms, improved methodological rigor in both preclinical and clinical non-invasive brain stimulation studies, standardization of outcome measures, increased clinical relevance in preclinical animal models, and greater optimization and individualization of non-invasive brain stimulation protocols. To facilitate the implementation of these recommendations, the expert panel developed a new SRRR3 Unified Non-Invasive Brain Stimulation Research Checklist.…”

Thanks to our reviewers, and editorial board changes

“…In a timely recognition of her enormous contribution, the most recent (third) round of SRRR was published just last month in IJS. [1][2][3][4] We are all very grateful to Julie for her contribution and wish her well in her future endeavors.…”