This article is part of a series on Noninvasive Brain stimulation, edited by Dr Edwards.

Review

Using non-invasive brain stimulation to augment motor training-induced plasticity

Nadia Bolognini^1,2,3 , Alvaro Pascual-Leone^1,3 and Felipe Fregni¹

¹  Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA

²  Department of Psychology, University of Milano Bicocca, Milano, Italy

³  Institut Guttmann de Neurorehabilitacio, Universitat Autonoma de Barcelona, Barcelona, Spain

author email corresponding author email

Journal of NeuroEngineering and Rehabilitation 2009, 6:8doi:10.1186/1743-0003-6-8

Published:	17 March 2009

Abstract

Therapies for motor recovery after stroke or traumatic brain injury are still not satisfactory. To date the best approach seems to be the intensive physical therapy. However the results are limited and functional gains are often minimal. The goal of motor training is to minimize functional disability and optimize functional motor recovery. This is thought to be achieved by modulation of plastic changes in the brain. Therefore, adjunct interventions that can augment the response of the motor system to the behavioural training might be useful to enhance the therapy-induced recovery in neurological populations. In this context, noninvasive brain stimulation appears to be an interesting option as an add-on intervention to standard physical therapies. Two non-invasive methods of inducing electrical currents into the brain have proved to be promising for inducing long-lasting plastic changes in motor systems: transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). These techniques represent powerful methods for priming cortical excitability for a subsequent motor task, demand, or stimulation. Thus, their mutual use can optimize the plastic changes induced by motor practice, leading to more remarkable and outlasting clinical gains in rehabilitation. In this review we discuss how these techniques can enhance the effects of a behavioural intervention and the clinical evidence to date.