Article

The rehabilitation of neuropsychological sequels of cerebral stroke such as
hemispatial neglect by noninvasive cortical stimulation (NICS) attracts
increasing attention from the scientific community. The NICS techniques include
primarily repetitive transcranial magnetic stimulation (rTMS) and transcranial
direct current stimulation (tDCS). They are based on the concept of either
reactivating a hypoactive cortical region affected by the stroke (the right
hemisphere in case of neglect) or reducing cortical hyperactivity of the
corresponding cortical region in the contralateral hemisphere (the left
hemisphere). In the studies published to date on the topic of neglect
rehabilitation, rTMS was used to inhibit the left parietal cortex and tDCS to
either activate the right or inhibit the left parietal cortex. Sham-controlled
NICS studies assessed short-term effects, whereas long-term effects were only
assessed in noncontrolled rTMS studies. Further controlled studies of large
series of patients are necessary to determine the best parameters of stimulation
(including the optimal cortical target location) according to each subtype of
neglect presentation and to the time course of stroke recovery. To date, even if
there are serious therapeutic perspectives based on imaging data and experimental
studies, the evidence is not compelling enough to recommend any particular NICS
protocol to treat this disabling condition in clinical practice.

Langue : ANGLAIS

Tiré à part : OUI