Opportunities for guided multichannel non-invasive transcranial current stimulation in post-stroke rehabilitation
Stroke is a leading cause of serious long-term disability worldwide. Functional outcome depends on stroke location, severity and early intervention. Conventional rehabilitation strategies have limited effectiveness, and new treatments still fail to keep pace, in part due to a lack of understanding o...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-02-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00021/full |
| _version_ | 1818501694361698304 |
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| author | Begonya eOtal Anirban eDutta Águida eFoerster Oscar eRipolles Amy eKuceyeski Pedro Cavaleiro Miranda Dylan J. Edwards Tihomir V. Ilić Michael A. Nitsche Michael A. Nitsche Giulio eRuffini Giulio eRuffini |
| author_facet | Begonya eOtal Anirban eDutta Águida eFoerster Oscar eRipolles Amy eKuceyeski Pedro Cavaleiro Miranda Dylan J. Edwards Tihomir V. Ilić Michael A. Nitsche Michael A. Nitsche Giulio eRuffini Giulio eRuffini |
| author_sort | Begonya eOtal |
| collection | DOAJ |
| description | Stroke is a leading cause of serious long-term disability worldwide. Functional outcome depends on stroke location, severity and early intervention. Conventional rehabilitation strategies have limited effectiveness, and new treatments still fail to keep pace, in part due to a lack of understanding of the different stages in brain recovery and the vast heterogeneity in the post-stroke population. Innovative methodologies for restorative neurorehabilitation are required to reduce long-term disability and socioeconomic burden. Neuroplasticity is involved in post-stroke functional disturbances, and also during rehabilitation. Tackling post-stroke neuroplasticity by non-invasive brain stimulation is regarded as promising, but efficacy might be limited because of rather uniform application across patients despite individual heterogeneity of lesions, symptoms and other factors. Transcranial direct current stimulation (tDCS) induces and modulates neuroplasticity, and has been shown to be able to improve motor and cognitive functions. tDCS is suited to improve post-stroke rehabilitation outcomes, but effect sizes are often moderate and suffer from variability. Indeed, the location, extent and pattern of functional network connectivity disruption should be considered when determining the optimal location sites for tDCS therapies. Here, we present potential opportunities for neuroimaging-guided tDCS-based rehabilitation strategies after stroke that could be personalized. We introduce innovative multimodal intervention protocols based on multichannel tDCS montages, neuroimaging methods and real-time closed-loop systems to guide therapy. This might help to overcome current treatment limitations in post-stroke rehabilitation and increase our general understanding of adaptive neuroplasticity leading to neural reorganization after stroke. |
| first_indexed | 2024-12-10T20:59:47Z |
| format | Article |
| id | doaj.art-5fc225f4cf2a4ea49d7ba8b56e7fea32 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T20:59:47Z |
| publishDate | 2016-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-5fc225f4cf2a4ea49d7ba8b56e7fea322022-12-22T01:33:50ZengFrontiers Media S.A.Frontiers in Neurology1664-22952016-02-01710.3389/fneur.2016.00021181593Opportunities for guided multichannel non-invasive transcranial current stimulation in post-stroke rehabilitationBegonya eOtal0Anirban eDutta1Águida eFoerster2Oscar eRipolles3Amy eKuceyeski4Pedro Cavaleiro Miranda5Dylan J. Edwards6Tihomir V. Ilić7Michael A. Nitsche8Michael A. Nitsche9Giulio eRuffini10Giulio eRuffini11Neuroelectrics BarcelonaINRIA (Sophia Antipolis), Université MontpellierUniversity of Medicine GoettingenNeuroelectrics BarcelonaDepartment of Radiology and the Brain and Mind Research Institute, Weill Cornell Medical CollegeIBEB, Faculdade de Ciências, Universidade de LisboaNon-Invasive Brain Stimulation and Human Motor Control Laboratory, Burke-Cornell Medical Research Institute, White PlainsDepartment of Clinical Neurophysiology, Military Medical AcademyLeibniz Research Centre for Working Environment and Human Factors, TU DortmundDepartment of Neurology, University Medical Hospital BergmannsheilNeuroelectrics BarcelonaStarlab BarcelonaStroke is a leading cause of serious long-term disability worldwide. Functional outcome depends on stroke location, severity and early intervention. Conventional rehabilitation strategies have limited effectiveness, and new treatments still fail to keep pace, in part due to a lack of understanding of the different stages in brain recovery and the vast heterogeneity in the post-stroke population. Innovative methodologies for restorative neurorehabilitation are required to reduce long-term disability and socioeconomic burden. Neuroplasticity is involved in post-stroke functional disturbances, and also during rehabilitation. Tackling post-stroke neuroplasticity by non-invasive brain stimulation is regarded as promising, but efficacy might be limited because of rather uniform application across patients despite individual heterogeneity of lesions, symptoms and other factors. Transcranial direct current stimulation (tDCS) induces and modulates neuroplasticity, and has been shown to be able to improve motor and cognitive functions. tDCS is suited to improve post-stroke rehabilitation outcomes, but effect sizes are often moderate and suffer from variability. Indeed, the location, extent and pattern of functional network connectivity disruption should be considered when determining the optimal location sites for tDCS therapies. Here, we present potential opportunities for neuroimaging-guided tDCS-based rehabilitation strategies after stroke that could be personalized. We introduce innovative multimodal intervention protocols based on multichannel tDCS montages, neuroimaging methods and real-time closed-loop systems to guide therapy. This might help to overcome current treatment limitations in post-stroke rehabilitation and increase our general understanding of adaptive neuroplasticity leading to neural reorganization after stroke.http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00021/fullNeuroimagingtranscranial direct current stimulationtDCSNear-infrared spectroscopy (NIRS)transcranial current stimulationMultichannel stimulation |
| spellingShingle | Begonya eOtal Anirban eDutta Águida eFoerster Oscar eRipolles Amy eKuceyeski Pedro Cavaleiro Miranda Dylan J. Edwards Tihomir V. Ilić Michael A. Nitsche Michael A. Nitsche Giulio eRuffini Giulio eRuffini Opportunities for guided multichannel non-invasive transcranial current stimulation in post-stroke rehabilitation Frontiers in Neurology Neuroimaging transcranial direct current stimulation tDCS Near-infrared spectroscopy (NIRS) transcranial current stimulation Multichannel stimulation |
| title | Opportunities for guided multichannel non-invasive transcranial current stimulation in post-stroke rehabilitation |
| title_full | Opportunities for guided multichannel non-invasive transcranial current stimulation in post-stroke rehabilitation |
| title_fullStr | Opportunities for guided multichannel non-invasive transcranial current stimulation in post-stroke rehabilitation |
| title_full_unstemmed | Opportunities for guided multichannel non-invasive transcranial current stimulation in post-stroke rehabilitation |
| title_short | Opportunities for guided multichannel non-invasive transcranial current stimulation in post-stroke rehabilitation |
| title_sort | opportunities for guided multichannel non invasive transcranial current stimulation in post stroke rehabilitation |
| topic | Neuroimaging transcranial direct current stimulation tDCS Near-infrared spectroscopy (NIRS) transcranial current stimulation Multichannel stimulation |
| url | http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00021/full |
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