New modalities of brain stimulation for stroke rehabilitation

被引：90
作者：
Edwardson, M. A. [1 ]
Lucas, T. H. [2 ]
Carey, J. R. [3 ]
Fetz, E. E. [4 ]
机构：
[1] NINDS, Stroke Branch, NIH, Bethesda, MD 20892 USA
[2] Univ Penn, Dept Neurosurg, Philadelphia, PA 19104 USA
[3] Univ Minnesota, Program Phys Therapy, Minneapolis, MN 55455 USA
[4] Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA
来源：
EXPERIMENTAL BRAIN RESEARCH | 2013年 / 224卷 / 03期
关键词：
Transcranial magnetic stimulation; Transcranial direct current stimulation; Epidural cortical stimulation; Activity-dependent; Stroke rehabilitation; Motor cortex; TRANSCRANIAL MAGNETIC STIMULATION; MOTOR CORTEX STIMULATION; UPPER-LIMB HEMIPARESIS; THETA-BURST STIMULATION; LOW-FREQUENCY RTMS; INTENSIVE OCCUPATIONAL-THERAPY; INDUCED MOVEMENT THERAPY; CORTICAL ELECTRICAL-STIMULATION; DEPENDENT PLASTICITY; SYNAPTIC PLASTICITY;
D O I：
10.1007/s00221-012-3315-1
中图分类号：
Q189 [神经科学];
学科分类号：
071006 ;
摘要：
Stroke is a leading cause of disability, and the number of stroke survivors continues to rise. Traditional neurorehabilitation strategies aimed at restoring function to weakened limbs provide only modest benefit. New brain stimulation techniques designed to augment traditional neurorehabilitation hold promise for reducing the burden of stroke-related disability. Investigators discovered that repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and epidural cortical stimulation (ECS) can enhance neural plasticity in the motor cortex post-stroke. Improved outcomes may be obtained with activity-dependent stimulation, in which brain stimulation is contingent on neural or muscular activity during normal behavior. We review the evidence for improved motor function in stroke patients treated with rTMS, tDCS, and ECS and discuss the mediating physiological mechanisms. We compare these techniques to activity-dependent stimulation, discuss the advantages of this newer strategy for stroke rehabilitation, and suggest future applications for activity-dependent brain stimulation.
引用
收藏
页码：335 / 358
页数：24
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