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Stroke rehabilitation using noninvasive cortical stimulation: motor deficit
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Stroke rehabilitation using noninvasive cortical stimulation: motor deficit
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Journal Article
Stroke rehabilitation using noninvasive cortical stimulation: motor deficit
2012
Overview
Noninvasive cortical stimulation (NICS) has been used during the acute, postacute and chronic poststroke phases to improve motor recovery in stroke patients having upper- and/or lower-limb paresis. This paper reviews the rationale for using the different NICS modalities to promote motor stroke rehabilitation. The changes in cortical excitability after stroke and the possible mechanisms of action of cortical stimulation in this context are outlined. A number of open and placebo-controlled trials have investigated the clinical effect of repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) of the primary motor cortex in patients with motor stroke. These studies attempted to improve motor performance by increasing cortical excitability in the stroke-affected hemisphere (via high-frequency rTMS or anodal tDCS) or by decreasing cortical excitability in the contralateral hemisphere (via low-frequency rTMS or cathodal tDCS). The goal of these studies was to reduce the inhibition exerted by the unaffected hemisphere on the affected hemisphere and to then restore a normal balance of interhemispheric inhibition. All these NICS techniques administered alone or in combination with various methods of neurorehabilitation were found to be safe and equally effective at the short term on various aspects of poststroke motor abilities. However, the long-term effect of NICS on motor stroke needs to be further evaluated before considering the use of such a technique in the daily routine management of stroke.
Publisher
Informa Healthcare,Taylor & Francis,Expert Reviews Ltd
Subject
/ Electric Stimulation Therapy - adverse effects
/ Electric Stimulation Therapy - methods
/ Electric Stimulation Therapy - trends
/ Humans
/ Methods
/ Motor Cortex - physiopathology
/ Motor Skills Disorders - etiology
/ Motor Skills Disorders - prevention & control
/ Paralysis - prevention & control
/ Paresis
/ Paresis - prevention & control
/ Stroke
/ transcranial direct current stimulation
/ Transcranial magnetic stimulation
/ Transcranial Magnetic Stimulation - adverse effects
