This review intends to synthesize our understanding of the effects of novel approach of non-invasive peripheral nerve and brain stimulation techniques in motor rehabilitation and the potential role of these techniques in clinical practice. The ability to induce cortical plasticity with non-invasive stimulation techniques has provided novel and exciting opportunities for examining the role of the human cortex during a variety of behaviors literature concerning non-invasive stimulation technique incorporated into stroke research is young, limiting the ability to draw consistent conclusions. In this review we discuss how these techniques can enhance the effects of a behavioral intervention and the clinical evidence for its use to date.
Brain ; Humans ; Peripheral Nerves ; Plastics ; Rehabilitation* ; Stroke*

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that modulates cortical excitability and influences cognition. The role of the primary motor cortex (M1) in cognition is controversial. Here, we investigated the offline effects of anodal and sham tDCS over M1 on cognitive tasks that require comparable motor skills, but different levels of working memory and attention. Twenty healthy young female adults received anodal tDCS and sham tDCS to the M1 on two separate testing days in a counter balanced order. The cognitive functions outcome variables were the response time from the Attention Switching Task (AST) and Motor Screening Task (MST) tests using the Cambridge Neuropsychological Test Automated Battery before and after the anodal/sham tDCS. Anodal tDCS significantly improved AST response times from baseline in congruent and incongruent condition and MST mean correct latency (all p < 0.05). There was a significant difference for AST tasks variable include AST Switching cost (mean, correct), AST Mean correct latency, in congruent, incongruent, blocks 3, 5 (non-switching blocks), block 7 (switching block) (p < 0.01) and MST mean latency (p < 0.05) between anodal and sham conditions. These results indicate that tDCS is a promising tool to an improvement in response time in task related attention and motor speed. However, this study warrants further research to determine the long-term effect on other cognitive functions and in different age and gender groups.
Adult ; Brain ; Cognition ; Female ; Humans ; Mass Screening ; Memory, Short-Term ; Motor Cortex ; Motor Skills ; Neuropsychological Tests ; Reaction Time ; Transcranial Direct Current Stimulation

This study aimed at identifying the frequency and final diagnoses of stroke mimics (SMs) among suspected stroke cases, and seeking differences in clinical & imaging features between SMs and true strokes. It was retrospective with data taken from an ongoing stroke registry for patients admitted to a Stroke Unit between 1 May and 31 October 2011. Baseline characteristics, clinical & imaging features, complications, and outcomes of SMs were compared to those with true strokes by appropriate statistical tests. The total number of cases admitted was 537. Only 232 (43.2%) of them presented during the critical time thrombolytic intervention. SMs comprised 15.9% of all suspected stroke cases. The commonest mimics were psychiatric disorders (43.2%), migraines (16.2%), seizures (8.1%), brain tumors (5.4%), and systemic infections (5.4%). SMs were younger, more common in females, with less evidence of preexisting hypertension (43.2% vs. 56.9% for true strokes). Hemianopia (p = 0.001), sensory inattention, neglect or both (p < 0.001) were more associated with true strokes, while cerebellar, brainstem signs or both (p = 0.045) excluding dysarthria were linked only to SMs. Acute ischemic signs in imaging scans were found linked to true strokes. Some clinical and imaging characteristics were found to differentiate to some extent between SMs and true strokes.
Brain Neoplasms ; Brain Stem ; Diagnosis ; Diagnosis, Differential ; Dysarthria ; Female ; Hemianopsia ; Humans ; Hypertension ; Migraine Disorders ; Retrospective Studies ; Seizures ; Stroke* ; Thrombolytic Therapy

Transcranial direct current stimulation (tDCS) is a noninvasive method that may increase the rehabilitation effects in stroke. The objective of the study was to test whether tDCS priming with training on an arm ergometer boosts motor performance in chronic stroke patients. Three chronic subcortical stroke patients had continued a sole unilateral stroke 30–36 months formerly. They had some voluntary control of the arm in the affected side underwent a cycling training on an arm ergometer for 20 minutes a day, during 5 days a week priming with cathodal tDCS stimulation of unaffected hemisphere. They were tested during 4 sessions 1 week before, at the beginning, at the end, and 1 week after the end of the training priming with tDCS. We executed; 1) Rivermead Motorik Assessment (global function, arm and leg), 2) the Modified Ashworth Scale of the elbow flexors and extensors, 3) the minimum torque on the lesion side, 4) grip strength, and 5) pegboard performance at each time of testing the patients. All patients tolerated tDCS very well during experiment. Patients showed significant (p = 0.01) improved of force and spasticity (p = 0.03). The grip strength and pegboard performance improved significantly too after DCS priming with training. These results showed that cathodal tDCS is a useful device for rehabilitation when priming with motor training in stroke patients. These patients proved the clinical relevance of the results.
Arm* ; Elbow ; Hand Strength ; Humans ; Methods ; Muscle Spasticity ; Neuronal Plasticity ; Paresis ; Pilot Projects* ; Rehabilitation ; Stroke ; Torque ; Transcranial Direct Current Stimulation*

Lance-Adams syndrome (LAS) is a rare neurological disorder that may occur after cardiopulmonary resuscitation. The LAS is usually caused by hypoxic changes.Neuroimaging studies show that the brain pathology of LAS patients is not uniform, and the pathophysiology of the myoclonus can vary from patient to patient. Our case study contributes to this etiological heterogeneity by neuroimaging and transcranial magnetic stimulation (TMS). In patients with rare brain conditions such as LAS, a combination of brain stimulation methods, such as TMS, and diffusion tensor imaging can provide insights into this condition's pathophysiology. These insights can facilitate the development of more effective therapies.