BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation
Volume 1, Issue 4 , Pages 326-336, October 2008

Efficacy of repetitive transcranial magnetic stimulation/transcranial direct current stimulation in cognitive neurorehabilitation

  • Carlo Miniussi, PhD

      Affiliations

    • Department of Biomedical Sciences and Biotechnology, National Institute of Neuroscience-Italy, University of Brescia and Cognitive Neuroscience Section, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy
    • Corresponding Author InformationCorrespondence: Prof. Carlo Miniussi, University of Brescia, Biomedical Sciences and Biotechnologists, Viale Europa 11, Brescia, 25123, Italy.
    • ,
  • Stefano F. Cappa, MD

      Affiliations

    • Department of Neuroscience, Vita Salute University-National Institute of Neuroscience-Italy and San Raffaele Scientific Institute, Milan, Italy
    • ,
  • Leonardo G. Cohen, MD

      Affiliations

    • Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic, NINDS, National Institutes of Health, Bethesda, Maryland
    • ,
  • Agnes Floel, MD

      Affiliations

    • Department of Neurology and IZKF, University of Münster, Münster, Germany
    • ,
  • Felipe Fregni, MD, PhD

      Affiliations

    • Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts
    • ,
  • Michael A. Nitsche, MD

      Affiliations

    • Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
    • ,
  • Massimiliano Oliveri, MD

      Affiliations

    • Department of Psychology University of Palermo and Fondazione “Santa Lucia” IRCCS, Roma, Italy
    • ,
  • Alvaro Pascual-Leone, MD, PhD

      Affiliations

    • Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts
    • ,
  • Walter Paulus, MD

      Affiliations

    • Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
    • ,
  • Alberto Priori, MD

      Affiliations

    • Clinical Center for Neuronanotechnology and Neurostimulation, Department of Neurological Sciences, University of Milan and IRCCS Ospedale Maggiore Policlinico, Milan, Italy
    • ,
  • Vincent Walsh, PhD

      Affiliations

    • Institute of Cognitive Neuroscience and Department of Psychology, University College London, London, United Kingdom

Received 22 May 2008; received in revised form 21 July 2008; accepted 21 July 2008. published online 06 October 2008.

Summary

Cognitive deficits are a common consequence of neurologic disease, in particular, of traumatic brain injury, stroke, and neurodegenerative disorders, and there is evidence that specific cognitive training may be effective in cognitive rehabilitation. Several investigations emphasize the fact that interacting with cortical activity, by means of cortical stimulation, can positively affect the short-term cognitive performance and improve the rehabilitation potential of neurologic patients. In this respect, preliminary evidence suggests that cortical stimulation may play a role in treating aphasia, unilateral neglect, and other cognitive disorders. Several possible mechanisms can account for the effects of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) on cognitive performance. They all reflect the potential of these methods to improve the subject's ability to relearn or to acquire new strategies for carrying out behavioral tasks. The responsible mechanisms remain unclear but they are most likely related to the activation of impeded pathways or inhibition of maladaptive responses. Modifications of the brain activity may assist relearning by facilitating local activity or by suppressing interfering activity from other brain areas. Notwithstanding the promise of these preliminary findings, to date no systematic application of these methods to neurorehabilitation research has been reported. Considering the potential benefit of these interventions, further studies taking into consideration large patient populations, long treatment periods, or the combination of different rehabilitation strategies are needed. Brain stimulation is indeed an exciting opportunity in the field of cognitive neurorehabilitation, which is clearly in need of further research.

Keywords: cognitive deficits, cognitive rehabilitation, memory, attention, language, repetitive transcranial magnetic stimulation, transcranial direct current stimulation

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PII: S1935-861X(08)00320-3

doi:10.1016/j.brs.2008.07.002

BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation
Volume 1, Issue 4 , Pages 326-336, October 2008

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