Cortical activation changes underlying stimulation-induced behavioural gains in chronic stroke.

Transcranial direct current stimulation, a form of non-invasive brain stimulation, is showing increasing promise as an adjunct therapy in rehabilitation following stroke. However, although significant behavioural improvements have been reported in proof-of-principle studies, the underlying mechanisms are poorly understood. The rationale for transcranial direct current stimulation as therapy for stroke is that therapeutic stimulation paradigms increase activity in ipsilesional motor cortical areas, but this has not previously been directly tested for conventional electrode placements.

Motor practice promotes increased activity in brain regions structurally disconnected after subcortical stroke.

Background: Motor practice is an important component of neurorehabilitation. Imaging studies in healthy individuals show that dynamic brain activation changes with practice. Defining patterns of functional brain plasticity associated with motor practice following stroke could guide rehabilitation.