The evolution of neuromodulation for chronic stroke: From neuroplasticity mechanisms to brain-computer interfaces

Neurotherapeutics. 2024 Apr;21(3):e00337. doi: 10.1016/j.neurot.2024.e00337. Epub 2024 Feb 19.

Abstract

Stroke is one of the most common and debilitating neurological conditions worldwide. Those who survive experience motor, sensory, speech, vision, and/or cognitive deficits that severely limit remaining quality of life. While rehabilitation programs can help improve patients' symptoms, recovery is often limited, and patients frequently continue to experience impairments in functional status. In this review, invasive neuromodulation techniques to augment the effects of conventional rehabilitation methods are described, including vagus nerve stimulation (VNS), deep brain stimulation (DBS) and brain-computer interfaces (BCIs). In addition, the evidence base for each of these techniques, pivotal trials, and future directions are explored. Finally, emerging technologies such as functional near-infrared spectroscopy (fNIRS) and the shift to artificial intelligence-enabled implants and wearables are examined. While the field of implantable devices for chronic stroke recovery is still in a nascent stage, the data reviewed are suggestive of immense potential for reducing the impact and impairment from this globally prevalent disorder.

Keywords: Brain-computer interface; Chronic stroke; Deep brain stimulation; Motor recovery; Vagus nerve stimulation.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Brain-Computer Interfaces* / trends
  • Chronic Disease
  • Deep Brain Stimulation* / methods
  • Deep Brain Stimulation* / trends
  • Humans
  • Neuronal Plasticity* / physiology
  • Stroke Rehabilitation* / methods
  • Stroke Rehabilitation* / trends
  • Stroke* / physiopathology
  • Stroke* / therapy
  • Vagus Nerve Stimulation* / methods
  • Vagus Nerve Stimulation* / trends