Brain stimulation: Neuromodulation as a potential treatment for motor recovery following traumatic brain injury

Abstract

There is growing evidence that electrical and magnetic brain stimulation can improve motor function and motor learning following brain damage. Rodent and primate studies have strongly demonstrated that combining cortical stimulation (CS) with skilled motor rehabilitative training enhances functional motor recovery following stroke. Brain stimulation following traumatic brain injury (TBI) is less well studied, but early pre-clinical and human pilot studies suggest that it is a promising treatment for TBI-induced motor impairments as well. This review will first discuss the evidence supporting brain stimulation efficacy derived from the stroke research field as proof of principle and then will review the few studies exploring neuromodulation in experimental TBI studies.

Combination therapies for neurobehavioral and cognitive recovery after experimental traumatic brain injury: Is more better?

“…Stem cell implantation combined with EE and therapies directed at attenuating neuroinflammation produced the highest number of successes and thus these viable promising approaches warrant continued research. Other non-pharmacological therapies that have shown some success when provided singly include electrical and magnetic brain stimulation (Li et al, 2015; Zhang et al, 2015; Clayton et al, 2016), constrained-induced movement therapy (Brady and Garcia, 2009) and low-level laser therapy (Oron et al, 2012; Xuan et al, 2013) and may potentially be more effective when augmented by a secondary therapy. Lastly, it is important that potential therapies be evaluated by several independent groups so that the results are replicated.…”

Increases in Microvascular Perfusion and Tissue Oxygenation via Vasodilatation After Anodal Transcranial Direct Current Stimulation in the Healthy and Traumatized Mouse Brain

“…Unfortunately, no effective therapies have yet been proven for TBI [2]. Transcranial direct current stimulation (tDCS) has emerged as a promising electroceutical therapeutic intervention suggested for TBI [3]; however, the mechanisms and optimal stimulation parameters have not yet been determined due to the lack of pre-clinical studies. Altered neuronal excitability is believed to underlie the immediate effects of tDCS; however, recent studies have shown that astrocytes are another possible target.…”

Neurostimulation and Reach-to-Grasp Function Recovery Following Acquired Brain Injury: Insight From Pre-clinical Rodent Models and Human Applications

“…Of the currently registered clinical trials using rTMS or tDCS for treatment of stroke or TBI, 85% are focused on stroke recovery (as of Dec 2019- Figure 3). Research on the applicability of NIBS as an intervention for recovery of motor deficits is in the nascent stages in TBI as compared to stroke (6,189,190). Despite this rapidly increasing interest in clinical applications, there is little consensus on the efficacy of such treatment protocols [for systematic reviews and meta-analyses, see (191)(192)(193)(194)(195)(196)(197)(198)].…”

“…Given that reach-to-grasp movements are a fundamental skill for many daily activities, improving reach-tograsp recovery after brain injury is a major goal of neurorehabilitation therapies (3,4). Non-invasive brain stimulation (NIBS) is of interest as both a prognostic tool for predicting motor recovery after brain injury and as a novel option for rehabilitation treatment (5)(6)(7)(8). When used as an intervention in clinical populations, NIBS techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have been shown to modulate localized regions of activity in the cortex and are administered either independently or in combination with task-specific training to promote functional recovery.…”