Repetitive transcranial magnetic stimulation and transcranial direct current stimulation in motor rehabilitation after stroke: an update

Authors:

Klomjai W; Lackmy-Vallee A; Roche N; Pradat-Diehl P; Marchand-Pauvert V; Katz R. Institution Klomjai, W. Faculty of Physical Therapy, Mahidol University, 73170 Nakonpathom, Thailand. Lackmy-Vallee, A. Inserm, laboratoire d’imagerie biomedicale, Sorbonne universites, UPMC universite Paris 06, CNRS, 75013 Paris, France. Roche, N. EA 4497, University Versailles-Saint-Quentin, Garches, France; Service d’explorations fonctionnelles, hopital Raymond-Poincare, AP-HP , 92380 Garches, France. Pradat-Diehl, P. Inserm, laboratoire d’imagerie biomedicale, Sorbonne universites, UPMC universite Paris 06, CNRS, 75013 Paris, France; Service de medecine physique et readaptation, groupe hospitalier Pitie-Salpetriere-Charles-Foix, AP-HP, France. Marchand-Pauvert, V. Inserm, laboratoire d’imagerie biomedicale, Sorbonne universites, UPMC universite Paris 06, CNRS, 75013 Paris, France. Katz, R. Inserm, laboratoire d’imagerie biomedicale, Sorbonne universites, UPMC universite Paris 06, CNRS, 75013 Paris, France; Service de medecine physique et readaptation, groupe hospitalier Pitie-Salpetriere-Charles-Foix, AP-HP, France. Electronic address: rose.katz@upmc.fr .

Title:

Repetitive transcranial magnetic stimulation and transcranial direct current stimulation in motor rehabilitation after stroke: an update. [Review]

Source: Annals of Physical & Rehabilitation Medicine. 58(4):220-4, 2015 Sep .

Abstract:

Stroke is a leading cause of adult motor disability. The number of stroke survivors is increasing in industrialized countries, and despite available treatments used in rehabilitation, the recovery of motor functions after stroke is often incomplete. Studies in the 1980s showed that non-inv asive brain stimulation (mainly repetitive transcranial magnetic stimulation [rTMS] and transcranial direct current stimulation [tDCS]) could modul ate cortical excitability and induce plasticity in healthy humans. These findings have opened the way to the therapeutic use of the 2 techniques for stroke. The mechanisms underlying the cortical effect of rTMS and t DCS differ. This paper summarizes data obtained in healthy subjects and gives a general review of the use of rTMS and tDCS in stroke patients with altered motor functions. From 1988 to 2012, approximately 1400 publications were devoted to the study of non-invasive brain stimulat ion in humans. However, for stroke patients with limb motor deficit, only 141 publications have been devoted to the effects of rTMS and 132 to th ose of tDCS. The Cochrane review devoted to the effects of rTMS found 19 randomized controlled trials involving 588 patients, and that devo ted to tDCS found 18 randomized controlled trials involving 450 patients. Without doubt, rTMS and tDCS contribute to physiological and pathoph ysiological studies in motor control. However, despite the increasing number of studies devoted to the possible therapeutic use of non-invasive brain stimulation to improve motor recovery after stroke, further studies will be necessary to specify their use in rehabilitation.

Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Publication Type: Journal Article. Review.