Rebooting the Brain: Non Invasive Brain Stimulation and the Future of Neurorehabilitation

Abstract

Non-Invasive Brain Stimulation (NIBS) is an emerging technology in neurorehabilitation with potential benefits to promote the neuroplasticity and functional recovery. This mini-review aims to summarize the recent clinical evidence evaluating the role of NIBS modalities- including repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), theta burst stimulation (TBS) - in neurorehabilitation settings. We explore the application of NIBS in major neurological conditions including spasticity and motor recovery in poststroke, spinal cord injury and cerebral palsy, gait in Parkinson’s disease and, cognitive improvement in traumatic brain injury. Recent evidence suggests that integrating NIBS with traditional therapies and with advanced technologies like virtual reality, robotic assisted therapies can further improve the functional outcome. Despite promising results, clinical heterogeneity, lack of standardized safety and treatment protocol and financial constraints limit its widespread use. There is a need for better clinical trials to guide its clinical application. NIBS has the potential to become an important component of evidence based neurorehabilitation interventions in the future.

Keywords: Repetitive Transcranial Magnetic Stimulation (rTMS), Transcranial Direct Current Stimulation (tDCS), theta burst stimulation (TBS), Stroke Rehabilitation, Neuroplasticity, Electrical stimulation transcranial