Article

Repetitive transcranial magnetic stimulation (rTMS) is emerging as a potentially
valuable intervention to augment the effects of behavioral therapy for stroke.
When used in conjunction with other therapies, rTMS embraces the concept of
metaplasticity. Due to homeostatic mechanisms inherent to metaplasticity,
interventions known to be in isolation to enhance excitability can interact when
applied successively under certain timing conditions and produce enhanced or
opposite effects. Similar to "muscular wisdom," with its self-protective
mechanisms, there also appears to be "synaptic wisdom" in neural networks with
homeostatic processes that prevent over- and under-excitability. These processes
have implications for both enhancing and suppressing the excitability effects
from behavioral therapy. The purpose of this article is to relate the concept of
metaplasticity, as derived from studies in humans who are healthy, to stroke
rehabilitation and consider how it can be leveraged to maximize stroke outcomes.

Langue : ANGLAIS