title: Non-invasive brain stimulation in neurorehabilitation: local and distant effects for motor recovery.
abstract: Non-invasive brain stimulation (NIBS) may enhance motor recovery after neurological injury through the causal induction of plasticity processes. Neurological injury, such as stroke, often results in serious long-term physical disabilities, and despite intensive therapy, a large majority of brain injury survivors fail to regain full motor function. Emerging research suggests that NIBS techniques, such as transcranial magnetic (TMS) and direct current (tDCS) stimulation, in association with customarily used neurorehabilitative treatments, may enhance motor recovery. This paper provides a general review on TMS and tDCS paradigms, the mechanisms by which they operate and the stimulation techniques used in neurorehabilitation, specifically stroke. TMS and tDCS influence regional neural activity underlying the stimulation location and also distant interconnected network activity throughout the brain. We discuss recent studies that document NIBS effects on global brain activity measured with various neuroimaging techniques, which help to characterize better strategies for more accurate NIBS stimulation. These rapidly growing areas of inquiry may hold potential for improving the effectiveness of NIBS-based interventions for clinical rehabilitation.
authors.affiliation: Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, NIH Bethesda, MD, USA.
authors.forename: Sook-Lei
authors.initials: SL
authors.lastname: Liew
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena Siena, Italy.
authors.forename: Emilliano
authors.initials: E
authors.lastname: Santarnecchi
authors.affiliation: Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, NIH Bethesda, MD, USA ; Center for Neuroscience and Regenerative Medicine, Uniformed Services University of Health Sciences Bethesda, MD, USA.
authors.forename: Ethan R
authors.initials: ER
authors.lastname: Buch
authors.affiliation: Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, NIH Bethesda, MD, USA ; Center for Neuroscience and Regenerative Medicine, Uniformed Services University of Health Sciences Bethesda, MD, USA.
authors.forename: Leonardo G
authors.initials: LG
authors.lastname: Cohen
keywords: neurorehabilitation; non-invasive brain stimulation; stroke; transcranial direct current stimulation (tDCS); transcranial magnetic stimulation