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Novel Non-invasive Brain Stimulation Techniques to Modify Brain Networks After Stroke

  • Ulf ZiemannEmail author
Conference paper
Part of the Biosystems & Biorobotics book series (BIOSYSROB, volume 15)

Abstract

Improving motor function after stroke is an in an important area of research in neurorehabilitation. Clinical trials using non-invasive brain stimulation (NIBS) to improve rehabilitation outcome after stroke showed modest effect sizes or even lack of efficacy [1, 2, 3]. One important reason for this limited therapeutic success may be too simplistic “one hat fits it all” strategies, e.g. aiming at increasing excitability in the ipsilesional primary motor cortex [4] that disregard high interindividual variability in responses to NIBS protocols, even in healthy subjects [5]. Several strategies that have been recently developed to improve therapeutic effect size of NIBS during stroke neurorehabilitation will be detailed in this presentation.

Keywords

Motor Cortex Motor Imagery Corticospinal Excitability Transcranial Direct Current Stimulation Event Related Desynchronization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    A.J. Butler, M. Shuster, E. O’Hara, K. Hurley, D. Middlebrooks, K. Guilkey, A meta-analysis of the efficacy of anodal transcranial direct current stimulation for upper limb motor recovery in stroke survivors. J. Hand Ther.: Official J. Am. Soc. Hand Therapists 26, 162–170 (2013). quiz 71CrossRefGoogle Scholar
  2. 2.
    W.Y. Hsu, C.H. Cheng, K.K. Liao, I.H. Lee, Y.Y. Lin, Effects of repetitive transcranial magnetic stimulation on motor functions in patients with stroke: a meta-analysis. Stroke; J. Cereb. Circ. 43, 1849–1857 (2012)CrossRefGoogle Scholar
  3. 3.
    J.P. Lefaucheur, N. Andre-Obadia, A. Antal et al., Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin. Neurophysiol. 125, 2150–2206 (2014)CrossRefGoogle Scholar
  4. 4.
    N.S. Ward, L.G. Cohen, Mechanisms underlying recovery of motor function after stroke. Arch. Neurol. 61, 1844–1848 (2004)CrossRefGoogle Scholar
  5. 5.
    M. Hamada, N. Murase, A. Hasan, M. Balaratnam, J.C. Rothwell, the role of interneuron networks in driving human motor cortical plasticity. Cereb. Cortex 23, 1593–1605 (2013)CrossRefGoogle Scholar
  6. 6.
    T. Wagner, F. Fregni, U. Eden et al., Transcranial magnetic stimulation and stroke: a computer-based human model study. NeuroImage. 30, 857–870 (2006)CrossRefGoogle Scholar
  7. 7.
    S. Bashir, D. Edwards, A. Pascual-Leone, Neuronavigation increases the physiologic and behavioral effects of low-frequency rTMS of primary motor cortex in healthy subjects. Brain Topogr. 24, 54–64 (2011)CrossRefGoogle Scholar
  8. 8.
    P. Celnik, N.J. Paik, Y. Vandermeeren, M. Dimyan, L.G. Cohen, Effects of combined peripheral nerve stimulation and brain polarization on performance of a motor sequence task after chronic stroke. Stroke J. Cereb. Circ. 40, 1764–1771 (2009)CrossRefGoogle Scholar
  9. 9.
    C. Grefkes, D.A. Nowak, S.B. Eickhoff et al., Cortical connectivity after subcortical stroke assessed with functional magnetic resonance imaging. Ann. Neurology. 63, 236–246 (2008)CrossRefGoogle Scholar
  10. 10.
    C. Grefkes, D.A. Nowak, L.E. Wang, M. Dafotakis, S.B. Eickhoff, G.R. Fink, Modulating cortical connectivity in stroke patients by rTMS assessed with fMRI and dynamic causal modelling. NeuroImage 50, 234–243 (2010)CrossRefGoogle Scholar
  11. 11.
    A. Flöel, F. Hummel, C. Breitenstein, S. Knecht, L.G. Cohen, Dopaminergic effects on encoding of a motor memory in chronic stroke. Neurology 65, 472–474 (2005)CrossRefGoogle Scholar
  12. 12.
    P. Jung, U. Ziemann, Homeostatic and non-homeostatic modulation of learning in human motor cortex. J. Neurosci. 29, 5597–5604 (2009)CrossRefGoogle Scholar
  13. 13.
    A. Avenanti, M. Coccia, E. Ladavas, L. Provinciali, M.G. Ceravolo, Low-frequency rTMS promotes use-dependent motor plasticity in chronic stroke: a randomized trial. Neurology 78, 256–264 (2012)CrossRefGoogle Scholar
  14. 14.
    A. Gharabaghi, D. Kraus, M.T. Leao et al., Coupling brain-machine interfaces with cortical stimulation for brain-state dependent stimulation: enhancing motor cortex excitability for neurorehabilitation. Front. Hum. Neurosci. 8, 122 (2014)Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Neurology and Stroke, and Hertie Institute for Clinical Brain ResearchUniversity of TübingenTübingenGermany

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