Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward?
During rehabilitation, a large proportion of stroke patients either plateau or begin to lose motor skills. By priming the motor system, transcranial direct current stimulation (tDCS) is a promising clinical adjunct that could augment the gains acquired during therapy sessions. However, the extent to...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/7/2601 |
| _version_ | 1797607668880244736 |
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| author | Claudia A. Salazar Wuwei Feng Leonardo Bonilha Steven Kautz Jens H. Jensen Mark S. George Nathan C. Rowland |
| author_facet | Claudia A. Salazar Wuwei Feng Leonardo Bonilha Steven Kautz Jens H. Jensen Mark S. George Nathan C. Rowland |
| author_sort | Claudia A. Salazar |
| collection | DOAJ |
| description | During rehabilitation, a large proportion of stroke patients either plateau or begin to lose motor skills. By priming the motor system, transcranial direct current stimulation (tDCS) is a promising clinical adjunct that could augment the gains acquired during therapy sessions. However, the extent to which patients show improvements following tDCS is highly variable. This variability may be due to heterogeneity in regions of cortical infarct, descending motor tract injury, and/or connectivity changes, all factors that require neuroimaging for precise quantification and that affect the actual amount and location of current delivery. If the relationship between these factors and tDCS efficacy were clarified, recovery from stroke using tDCS might be become more predictable. This review provides a comprehensive summary and timeline of the development of tDCS for stroke from the viewpoint of neuroimaging. Both animal and human studies that have explored detailed aspects of anatomy, connectivity, and brain activation dynamics relevant to tDCS are discussed. Selected computational works are also included to demonstrate how sophisticated strategies for reducing variable effects of tDCS, including electric field modeling, are moving the field ever closer towards the goal of personalizing tDCS for each individual. Finally, larger and more comprehensive randomized controlled trials involving tDCS for chronic stroke recovery are underway that likely will shed light on how specific tDCS parameters, such as dose, affect stroke outcomes. The success of these collective efforts will determine whether tDCS for chronic stroke gains regulatory approval and becomes clinical practice in the future. |
| first_indexed | 2024-03-11T05:33:05Z |
| format | Article |
| id | doaj.art-acfb25200e004c00abeb875787b4c528 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T05:33:05Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-acfb25200e004c00abeb875787b4c5282023-11-17T16:59:22ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01127260110.3390/jcm12072601Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward?Claudia A. Salazar0Wuwei Feng1Leonardo Bonilha2Steven Kautz3Jens H. Jensen4Mark S. George5Nathan C. Rowland6Department of Neurosurgery, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USADepartment of Neurology, Duke University School of Medicine, Durham, NC 27710, USADepartment of Neurology, College of Medicine, Emory University, Atlanta, GA 30322, USADepartment of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USACenter for Biomedical Imaging, University of South Carolina, Columbia, SC 29208, USADepartment of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USADepartment of Neurosurgery, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USADuring rehabilitation, a large proportion of stroke patients either plateau or begin to lose motor skills. By priming the motor system, transcranial direct current stimulation (tDCS) is a promising clinical adjunct that could augment the gains acquired during therapy sessions. However, the extent to which patients show improvements following tDCS is highly variable. This variability may be due to heterogeneity in regions of cortical infarct, descending motor tract injury, and/or connectivity changes, all factors that require neuroimaging for precise quantification and that affect the actual amount and location of current delivery. If the relationship between these factors and tDCS efficacy were clarified, recovery from stroke using tDCS might be become more predictable. This review provides a comprehensive summary and timeline of the development of tDCS for stroke from the viewpoint of neuroimaging. Both animal and human studies that have explored detailed aspects of anatomy, connectivity, and brain activation dynamics relevant to tDCS are discussed. Selected computational works are also included to demonstrate how sophisticated strategies for reducing variable effects of tDCS, including electric field modeling, are moving the field ever closer towards the goal of personalizing tDCS for each individual. Finally, larger and more comprehensive randomized controlled trials involving tDCS for chronic stroke recovery are underway that likely will shed light on how specific tDCS parameters, such as dose, affect stroke outcomes. The success of these collective efforts will determine whether tDCS for chronic stroke gains regulatory approval and becomes clinical practice in the future.https://www.mdpi.com/2077-0383/12/7/2601strokeneuromodulationtranscranial direct current stimulationmagnetic resonance imaging |
| spellingShingle | Claudia A. Salazar Wuwei Feng Leonardo Bonilha Steven Kautz Jens H. Jensen Mark S. George Nathan C. Rowland Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward? Journal of Clinical Medicine stroke neuromodulation transcranial direct current stimulation magnetic resonance imaging |
| title | Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward? |
| title_full | Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward? |
| title_fullStr | Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward? |
| title_full_unstemmed | Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward? |
| title_short | Transcranial Direct Current Stimulation for Chronic Stroke: Is Neuroimaging the Answer to the Next Leap Forward? |
| title_sort | transcranial direct current stimulation for chronic stroke is neuroimaging the answer to the next leap forward |
| topic | stroke neuromodulation transcranial direct current stimulation magnetic resonance imaging |
| url | https://www.mdpi.com/2077-0383/12/7/2601 |
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