Transcranial Direct Current Stimulation for Motor Recovery Following Brain Injury

Abstract

To discuss the potential use of transcranial direct current stimulation (tDCS) to improve motor behavior after brain injury. Despite evidence that tDCS can improve motor function following brain injury, meta-analysis studies have largely failed to find conclusive support for tDCS as a viable treatment. In part, these inconsistencies arise from widespread variability in individuals’ responsiveness to tDCS because of biological and experimental factors. Properly designed smart clinical studies are still needed to determine the optimal stimulation parameters and combinations of tDCS. However, some patterns of “best practice” have begun to emerge: (1) pairing tDCS concurrently with high-intensity motor training as opposed to before, after, or in the absence of physical practice, (2) repeating sessions of stimulation in close succession over a single administration, (3) administering stimulation during more acute periods of recovery over chronic states, and (4) utilizing modeling techniques based on individual anatomy to tailor electrode placement and optimize current flow.