Searching for the optimal tDCS target for motor rehabilitation

[en] Background: Transcranial direct current stimulation (tDCS) has been investigated over the years due to its short and also long-term effects on cortical excitability and neuroplasticity. Although its mechanisms to improve motor function are not fully understood, this technique has been suggested as an alternative therapeutic method for motor rehabilitation, especially those with motor function deficits. When applied to the primary motor cortex, tDCS has shown to improve motor function in healthy individuals, as well as in patients with neurological disorders. Based on its potential effects on motor recovery, identifying optimal targets for tDCS stimulation is essential to improve knowledge regarding neuromodulation as well as to advance the use of tDCS in clinical motor rehabilitation. Methods and results: Therefore, this review discusses the existing evidence on the application of four different tDCS montages to promote and enhance motor rehabilitation: (1) anodal ipsilesional and cathodal contralesional primary motor cortex tDCS, (2) combination of central tDCS and peripheral electrical stimulation, (3) prefrontal tDCS montage and (4) cerebellar tDCS stimulation. Although there is a significant amount of data testing primary motor cortex tDCS for motor recovery, other targets and strategies have not been sufficiently tested. This review then presents the potential mechanisms and available evidence of these other tDCS strategies to promote motor recovery. Conclusions: In spite of the large amount of data showing that tDCS is a promising adjuvant tool for motor rehabilitation, the diversity of parameters, associated with different characteristics of the clinical populations, has generated studies with heterogeneous methodologies and controversial results. The ideal montage for motor rehabilitation should be based on a patient-tailored approach that takes into account aspects related to the safety of the technique and the quality of the available evidence. © 2019 The Author(s).

Disciplines :

Neurology

Author, co-author :

Santos Ferreira, I.; Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, United States

Teixeira Costa, B.; Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, United States

Lima Ramos, C.; Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, United States

Lucena, P.; Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, United States

Thibaut, Aurore ; Université de Liège - ULiège > Consciousness-Coma Science Group

Fregni, F.; Neuromodulation Center, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, 79/96 13th Street, Charlestown, MA 02129, United States

Language :

English

Title :

Searching for the optimal tDCS target for motor rehabilitation

Publication date :

2019

Journal title :

Journal of NeuroEngineering and Rehabilitation

eISSN :

1743-0003

Publisher :

BioMed Central Ltd.

Volume :

Issue :

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 27 December 2020

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