Gowan Samuel, Hordacre Brenton
Interdisciplinary Neuroscience Program, Department of Biology, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA.
IIMPACT in Health, University of South Australia, Adelaide, SA 5001, Australia.
Brain Sci. 2020 May 21;10(5):310. doi: 10.3390/brainsci10050310.
Stroke remains a global leading cause of disability. Novel treatment approaches are required to alleviate impairment and promote greater functional recovery. One potential candidate is transcranial direct current stimulation (tDCS), which is thought to non-invasively promote neuroplasticity within the human cortex by transiently altering the resting membrane potential of cortical neurons. To date, much work involving tDCS has focused on upper limb recovery following stroke. However, lower limb rehabilitation is important for regaining mobility, balance, and independence and could equally benefit from tDCS. The purpose of this review is to discuss tDCS as a technique to modulate brain activity and promote recovery of lower limb function following stroke. Preliminary evidence from both healthy adults and stroke survivors indicates that tDCS is a promising intervention to support recovery of lower limb function. Studies provide some indication of both behavioral and physiological changes in brain activity following tDCS. However, much work still remains to be performed to demonstrate the clinical potential of this neuromodulatory intervention. Future studies should consider treatment targets based on individual lesion characteristics, stage of recovery (acute vs. chronic), and residual white matter integrity while accounting for known determinants and biomarkers of tDCS response.
中风仍然是全球导致残疾的主要原因。需要新的治疗方法来减轻损伤并促进更大程度的功能恢复。一种潜在的候选方法是经颅直流电刺激（tDCS），它被认为通过短暂改变皮层神经元的静息膜电位来非侵入性地促进人类皮层内的神经可塑性。迄今为止，许多涉及tDCS的研究都集中在中风后的上肢恢复。然而，下肢康复对于恢复活动能力、平衡和独立性很重要，并且同样可以从tDCS中受益。本综述的目的是讨论tDCS作为一种调节大脑活动并促进中风后下肢功能恢复的技术。来自健康成年人和中风幸存者的初步证据表明，tDCS是支持下肢功能恢复的一种有前景的干预措施。研究提供了一些tDCS后大脑活动行为和生理变化的迹象。然而，仍有许多工作要做，以证明这种神经调节干预的临床潜力。未来的研究应根据个体病变特征、恢复阶段（急性与慢性）和残余白质完整性来考虑治疗靶点，同时考虑tDCS反应的已知决定因素和生物标志物。
