Assessment and Modulation of Neural Plasticity in Rehabilitation With Transcranial Magnetic Stimulation

Abstract

Despite intensive efforts towards the improvement of outcomes after acquired brain injury functional recovery is often limited. One reasons is the challenge in assessing and guiding plasticity after brain injury. In this context, Transcranial Magnetic Stimulation (TMS) - a noninvasive tool of brain stimulation - could play a major role. TMS has shown to be a reliable tool to measure plastic changes in the motor cortex associated with interventions in the motor system; such as motor training and motor cortex stimulation. In addition, as illustrated by the experience in promoting recovery from stroke, TMS a promising therapeutic tool to minimize motor, speech, cognitive, and mood deficits. In this review, we will focus on stroke to discuss how TMS can provide insights into the mechanisms of neurological recovery, and can be used for measurement and modulation of plasticity after an acquired brain insult.

Optogenetic neuronal stimulation promotes functional recovery after stroke

“…The primary motor cortex (M1) is a commonly stimulated area as it directly innervates the corticospinal tract to initiate movement (1,7). Although electrical stimulation and transcranial magnetic stimulation show promise in promoting recovery (17,18), these techniques are limited by imprecision and indiscriminate activation or inhibition of all cell types near the stimulated site; thus, they can produce undesired effects such as psychiatric and motor/speech problems (19)(20)(21). In addition, it has been difficult to elucidate the cell type and mechanisms driving recovery, as multiple cell types such as neurons, astrocytes, and oligodendrocytes have been shown to contribute to remodeling and recovery processes after stroke (5,(22)(23)(24)(25)(26)(27).…”

Optogenetic Approaches to Target Specific Neural Circuits in Post-stroke Recovery

“…Various strategies have been shown to enhance recovery in preclinical models and patients, including pharmacological treatment, rehabilitation (e.g., constraint-induced therapy) [32][33][34], stem cell transplantation [35,36], and brain stimulation [37][38][39][40][41][42][43]. In particular, brain stimulation is a promising area of research because it allows direct activation and manipulation of the target area's excitability.…”

“…In particular, brain stimulation is a promising area of research because it allows direct activation and manipulation of the target area's excitability. A number of studies have used invasive and noninvasive brain stimulation techniques to study recovery after stroke [37][38][39][40][41][42][43]. These include cortical microelectrode stimulation, deep brain stimulation, transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS).…”

Observation of Tumour-induced Reorganization in Structural and Functional Architecture of the Brain in Three Pre-surgical Patients with Left Frontal-temporal Brain Tumour: A Combination of MEG, DTI and Neuropsychological Assessment

“…The purpose of this mechanism is to optimise the functioning of brain networks (Bashir et al 2010;Bavelier & Neville 2002). Hypotheses have been proposed to elucidate the pathophysiological fundamental mechanism of neural plasticity.…”

“…Neuroplasticity has a critical role during learning and recovery from lesions in the peripheral nervous system and CNS. The behavioural consequence of this mechanism has been investigated recently in human (Bashir et al 2010;Begley & Check 2000). However, the observation of neuroplasticity and the pattern of brain reorganization and changes involved in the patients with brain tumour and the effects to the surrounding functional areas have not been documented using combination of neuroimaging techniques such as magnetoencephalography (MEG) and diffusion tensor imaging (DTI).…”