Noninvasive Brain Stimulation for Neurorehabilitation in Post-Stroke Patients

Abstract

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.

The effectiveness and safety of noninvasive brain stimulation technology combined with speech training on aphasia after stroke: A systematic review and meta-analysis

“…In addition, treatment parameters such as stimulation site, frequency, intensity, and duration are also important factors affecting the therapeutic effect. [ 48 ] In the rTMS studies included in this study, low-frequency stimulation (≤ 1 Hz) was predominant. Only 1 study had high-frequency stimulation (> 1 Hz), and the coil was primarily placed in the right mirror area of speech function when low-frequency stimulation was performed.…”

Exploring the Frontiers of Neuroimaging: A Review of Recent Advances in Understanding Brain Functioning and Disorders

“…TES is a non-invasive brain stimulation technique that involves applying low-intensity electrical currents to the scalp to modulate brain activity [49][50][51]. In recent years, several advances in TES technology have improved its effectiveness and expanded its potential applications.…”

Bridging the Gap between Basic Research and Clinical Practice: The Growing Role of Translational Neurorehabilitation

“…Non-invasive brain stimulation (NIBS) or neuromodulation techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), can be used to enhance post-injury recovery [ 48 ]. In fact, NIBS modulates the central nervous system by activating neurons in the brain and cortical excitability in order to further potentiate neuroplastic processes during rehabilitation training [ 49 ]. In particular, the combined use of VR and rTMS could improve the effects of rehabilitation by modulating the activity of damaged brain circuits to provide a beneficial effect [ 50 ].…”