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Effects of Navigated Transcranial Magnetic Stimulation Priming with Transcranial Direct Current (DC) Stimulation Coupled with Constraint-Induced Movement Therapy on Motor Function of Stroke Patients

Shahid Bashir, Fawaz Al-Hussain, Fahad Al-Sultan, Ali Hamza, Niaz Asim, Woo-Kyoung Yoo

Med Sci Hypotheses 2015; 5:6-12

DOI: 10.12659/MSH.910512

ABSTRACT: Motor deficits are common after stroke and are a major contributor to stroke-related disability and the potential for long-lasting neurobiological consequences of stroke remains unresolved. There are only a few treatments available for the improvement of motor function in stroke patients. However, the mechanisms underlying stroke recovery remain poorly understood, and effective neurorehabilitation interventions remain insufficiently proven for widespread implementation. Herein, we propose to enhance the effects of brain plasticity using a powerful noninvasive technique for brain modulation consisting of navigated transcranial magnetic stimulation (TMS) priming with transcranial direct current stimulation (tDCS) in combination with motor-training-like constraint-induced movement therapy (CIMT).
Our hypothesis is that navigated low-frequency rTMS stimulus priming with precise location provided by neuronavigation on the healthy side of the brain and with anodal tDCS on the affected side combined with CIMT will induce a greater motor function improvement than that obtained with sham tDCS combined with CIMT alone. We predict that the application of this technique will result in a large reduction in cortical excitability and dis-inhibition in the affected hemisphere and lead to improvements in behavioral measures of hand function in stroke patients. The proposed study, therefore, is important for several reasons. The results could potentially lead to improved stroke therapeutics and the approach makes use of 2 potential pathways to modulate brain function.

Keywords: Electromagnetic Phenomena, Rehabilitation Centers, Stroke

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