KAMALJEET
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Research and Medical Writing Abstract
Non-Invasive Brain Stimulation in Post-Stroke Rehabilitation: Current Evidence and Future Directions
Stroke remains one of the leading causes of long-term disability in the world, with physical, cognitive and linguistic impairment causing major impact on the quality of life. As traditional forms of rehabilitation are often not enough to result in complete recovery, other neuromodulatory therapy is of interest. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are two types of non-invasive brain stimulation (NIBS) that have shown promise in stimulating neuroplasticity and functional recovery in stroke survivors. These modalities promote reorganisation of the perilesional and contralesional networks and modulate cortical excitability and inter-hemispheric balance. Although due to variations in patient demographics and stimulation parameters, generalizability is limited, existing clinical trial and meta-analysis evidence demonstrate that NIBS is associated with enhanced cognitive function, language recovery and motor recovery. Despite good safety profiles, optimum stimulation regimens, timing issues as to when to begin stroke, and combination with standard therapy have still been of concern. Innovations in more personalized methods such as neuronavigation, closed-loop stimulation and biomarker-directed selection could enhance efficacy and translatability. The summary of the latest research on the subject provided in this review, the possible future directions of clinical implementation of NIBS, and the highlighting of the mechanical basis of the NIBS mechanisms in post-stroke rehabilitation. Mechanistic understanding and accurate rehabilitation steps could potentially change the recovery courses of stroke victims.
KEYWORDS: Non-invasive brain stimulation, Post-stroke rehabilitation, Neuroplasticity, Transcranial magnetic stimulation, Transcranial direct current stimulation
