The role of neuromodulation to drive neural plasticity in stroke recovery

Abstract

Stroke is one of the leading causes of death and adult disability globally, representing one of the highest burdens of disease worldwide. Recent advancements of neuromodulation techniques emerge as promising tools for enhancing stroke recovery, such as transcranial electric stimulation and transcranial magnetic stimulation, which can induce short- and long-term changes of synaptic excitability to restore the impaired functions in stroke patients. The review focuses on discussing the neuroplastic mechanisms of those brain stimulation techniques in stroke rehabilitation, also including some new options for neuromodulation which have great potential in stroke rehabilitation, such as optogenetic stimulation and environmental stimulation. In general, these techniques allow the excitation and synchronization of the neural activity after stroke, which could potentially induce long-term potentiation. As a result, the neuroplastic effect can lead to better functional connection in the brain network in assisting stroke recovery. Future directions include the clarification of the pathways of synaptic plasticity in the whole brain network following neuromodulation after stroke, and investigation of the different roles of distinctive cell populations in neural plasticity enhancement. Additional studies are essential for developing standard protocols in neuromodulation based on a better understanding of the molecular and cellular processes for the ultimate optimization of clinical efficacy.

Efficacy on gait and posture control after botulinum toxin A injection for lower-limb spasticity treatment after stroke: A randomized controlled trial

“…Stroke is one of the leading causes of death and adult disability globally ( Wang, 2022 ). A total of 75% of patients who sustain a stroke have limitations in walking ( Abilleira et al, 2005 ), and the most common pattern of walking impairment post-stroke is hemiparetic gait.…”

Fyn Signaling in Ischemia-Reperfusion Injury: Potential and Therapeutic Implications

“…On the one hand, the upregulation of Fyn through neuromodulation may also benefit several aspects such as neuronal migration, synaptogenesis, and synaptic plasticity [ 100 , 101 ]. Neuromodulation is essential for synaptogenesis and plasticity [ 102 ]. Increasing Fyn activity promotes actin dynamics allowing oligodendrocyte maturation and facilitating synaptic regeneration, and subsequent myelin production [ 103 ].…”

Low-Intensity Focused Ultrasound Alleviates Spasticity and Increases Expression of the Neuronal K-Cl Cotransporter in the L4–L5 Sections of Rats Following Spinal Cord Injury

“…Most studies have reported that neuromodulation techniques have been extensively studied and proved to be effetely in many diseases' treatment (Pan et al, 2022 ; Wang, 2022 ), such as repetitive functional magnetic stimulation (rFMS) alleviated the urinary retention for the patients after spinal cord injury (Zhang et al, 2022 ), promote the rehabilitation after brain tumor surgery (Dadario et al, 2022 ); Electrical nerve stimulation, which has been used for treating neuropathic pain, has been shown to be an effective treatment for reducing spasticity (Fernández-Tenorio et al, 2019 ; Tapia Pérez, 2019 ). The reduction in spasticity by functional electrical stimulation (FES) has also been confirmed by clinical studies, including a significant reduction in quadriceps tone in incomplete spinal cord patients and an increase in voluntary muscle strength after receiving FES (Granat et al, 1993 ).…”