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. 2024 Jul 28;13(15):4420.
doi: 10.3390/jcm13154420.

Facilitating Corticomotor Excitability of the Contralesional Hemisphere Using Non-Invasive Brain Stimulation to Improve Upper Limb Motor Recovery from Stroke-A Scoping Review

Pui Kit Tam  1   2 , Nicodemus Edrick Oey  1   2 , Ning Tang  1 , Guhan Ramamurthy  3 , Effie Chew  1   2
Affiliations

Facilitating Corticomotor Excitability of the Contralesional Hemisphere Using Non-Invasive Brain Stimulation to Improve Upper Limb Motor Recovery from Stroke-A Scoping Review

Pui Kit Tam et al. J Clin Med. .

Abstract

Upper limb weakness following stroke poses a significant global psychosocial and economic burden. Non-invasive brain stimulation (NIBS) is a potential adjunctive treatment in rehabilitation. However, traditional approaches to rebalance interhemispheric inhibition may not be effective for all patients. The supportive role of the contralesional hemisphere in recovery of upper limb motor function has been supported by animal and clinical studies, particularly for those with severe strokes. This review aims to provide an overview of the facilitation role of the contralesional hemisphere for post-stroke motor recovery. While more studies are required to predict responses and inform the choice of NIBS approach, contralesional facilitation may offer new hope for patients in whom traditional rehabilitation and NIBS approaches have failed.

Keywords: intracerebral hemorrhage; non-invasive brain stimulation; stroke; upper limb impairment.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart detailing systematic review process.
Figure 2
Figure 2
Selected possible biomarkers in choosing which NIBS protocols to use, accounting for severity of stroke (FM-UE: Fugl–Meyer Assessment for the Upper Extremity) and integrity of corticospinal tract (PLIC FA: posterior limb of internal capsule fractional anisotropy). iM1 = ipsilesional motor cortex; cM1 = contralesional motor cortex; cPMD = contralesional dorsal premotor cortex; iPMD = ipsilesional dorsal premotor cortex; DTI = Diffusion Tensor Imaging; FA = Fractional Anisotropy; FMA-UE = Fugl-Meyer Assessment–Upper Extremity; CST = Corticospinal Tract; ERD = Event Related Desynchronization; MEP = Motor Evoked Potential; iSP = Ipsilateral Silent Period.
See this image and copyright information in PMC

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