Non-Invasive Brain Stimulation (TMS/tDCS) and Rehabilitation for Stroke and Parkinson’s

Abstract

The aim of this study was to clarify and compare the efficacies of rehabilitation using transcranial direct current stimulation (tDCS) and continuous theta burst stimulation (cTBS), a form of repetitive transcranial magnetic stimulation (rTMS), in convalescing stroke and Parkinson's disease patients. For both types of stimuli, kinetic analysis and performance analysis of upper limb motor paralysis and gait analysis showed an increase in speed of movement, and an improvement in performance was observed. Both stimuli resulted in significant improvement compared with a sham stimulus. Change in speed of movement and performance was observed with both tDCS and cTBS, but there was not a significantly large difference between the stimuli. Improved movement due to reduction of excessive tension caused by spasticity was observed. In patients with Parkinson's disease, gait speed and step length were increased. It is suggested that performance was improved because movement became smoother. The efficacy of tDCS and cTBS in patients with motor disorders caused by stroke or Parkinson's disease will probably be further improved when combined with physical therapy.

Defining the concept of reserve in the motor domain: a systematic review

“…Interestingly, recent studies are also highlighting the possible role of non-invasive brain stimulation (NIBS) for the assessment and the potentiation of the cerebellar reserve ( Manto, 2023 ). NIBS has been promoted as a safe and reliable tool for causal validation of theoretical models and modulation of brain activity with extensive application in the motor domain in both healthy individuals and patients ( Matsuda et al, 2017 ; Giustiniani et al, 2019 , 2021 ; Learmonth et al, 2021 ; Calderone et al, 2024 ). Recently, transcranial magnetic stimulation (TMS) has been used to probe the bimodal balance recovery theory which suggests that, in case of stroke, contralesional influence changes based on the amount of ipsilesional reserve (i.e., it would be inhibitory when there is a high level of ipsilateral reserve and supportive in case of a low level) ( Li et al, 2022 ).…”