Hordacre Brenton, Moezzi Bahar, Ridding Michael C
Body in Mind, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.
Cognitive Ageing and Impairment Neurosciences Laboratory, School of Psychology, Social Work and Social Policy, University of South Australia, Magill, SA, Australia.
J Exp Neurosci. 2018 Nov 5;12:1179069518809060. doi: 10.1177/1179069518809060. eCollection 2018.
Stroke is a leading cause of adult disability. New treatments capable of assisting recovery hold significant potential to improve quality of life for many stroke survivors. Transcranial direct current stimulation is one technique that has received much attention due to its potential to promote neuroplasticity and enhance recovery. However, current evidence suggests this is not a one-size-fits-all treatment with indication that responses are highly variable. Using electroencephalography, Hordacre et al recently demonstrated that connectivity between the ipsilesional motor cortex, ipsilesional parietal cortex, and contralesional frontotemporal cortex was a strong predictor of the neurophysiological response to anodal transcranial direct current stimulation applied to the ipsilesional motor cortex in people with chronic ischemic stroke. Based on this outcome, we discuss the potential for connectivity to be used as a biomarker to target transcranial direct current stimulation. This includes identification of a connectivity threshold which could be used to select stroke survivors who are likely to respond to this potentially beneficial neuromodulatory treatment. Furthermore, we discuss treatment approaches for those identified as unlikely to benefit from ipsilesional anodal transcranial direct current stimulation based on connectivity profile. This represents an important progression towards targeting transcranial direct current stimulation for best treatment outcome based on individual connectivity characteristics.
中风是成人残疾的主要原因。能够辅助恢复的新疗法对于改善许多中风幸存者的生活质量具有巨大潜力。经颅直流电刺激是一种备受关注的技术，因为它具有促进神经可塑性和增强恢复的潜力。然而，目前的证据表明，这并非一种适用于所有人的治疗方法，有迹象表明反应存在很大差异。霍达克等人最近利用脑电图证明，在慢性缺血性中风患者中，患侧运动皮层、患侧顶叶皮层和对侧额颞叶皮层之间的连接性是对应用于患侧运动皮层的阳极经颅直流电刺激产生神经生理反应的有力预测指标。基于这一结果，我们讨论了将连接性用作经颅直流电刺激靶点生物标志物的可能性。这包括确定一个连接性阈值，该阈值可用于选择可能对这种潜在有益的神经调节治疗有反应的中风幸存者。此外，我们还讨论了针对那些根据连接性特征被确定不太可能从患侧阳极经颅直流电刺激中获益的患者的治疗方法。这代表了朝着基于个体连接性特征将经颅直流电刺激靶向以实现最佳治疗效果迈出的重要一步。
