Neurorehabilitation: Five new things

Abstract

Neurologists have a new toolbox of options for neurorehabilitation of disabling brain disorders such as stroke and traumatic brain injury. An emerging intellectual paradigm for neurologic recovery that includes neural regeneration, repair, and dynamic reorganization of functional neural systems, as well as increasing awareness of behavioral principles that may support best return to function and freedom, brought forward treatments based on experience-dependent learning, neurophysiologic stimulation, and a combination of these concepts. In this article, we summarize five rehabilitative approaches to watch: constraint therapy for motor and language recovery, synergy of motor-language rehabilitation, prism adaptation training and other virtual feedback approaches, and noninvasive magnetic and electrical brain stimulation.

Figure 1. Rehabilitation of spatial neglect by prism adaptation training: Wedge prism goggles

Optical prism goggles used for prism adaptation therapy (photo credit: Joan Banks for the Kessler Foundation, with permission).

Figure 2. Transcranial magnetic stimulation of the brain using neuronavigation

Transcranial magnetic stimulation setup for measuring the motor evoked potential using neuronavigation guidance (photo credit: Nextstim, with permission).

Figure 3. Transcranial direct current stimulation: Equipment setup for treatment administration

Transcranial direct current stimulation (tDCS): electrode (inside sponge) placement on the head for bilateral parietal stimulation (left side of figure; photo credit: Kessler Foundation, with permission) and an example of tDCS stimulator controls (right side of figure; photo credit: Soterix Medical, with permission).