https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5298973/
Abstract
Transcranial
direct current stimulation (tDCS) is a non-invasive brain stimulation
method to modulate the local field potential in neural tissue and
consequently, cortical excitability. As tDCS is relatively portable,
affordable, and accessible, the applications of tDCS to probe
brain–behavior connections have rapidly increased in the last 10 years.
One of the most promising applications is the use of tDCS to modulate
excitability in the motor cortex after stroke and promote motor
recovery. However, the results of clinical studies implementing tDCS to
modulate motor excitability have been highly variable, with some studies
demonstrating that as many as 50% or more of patients fail to show a
response to stimulation. Much effort has therefore been dedicated to
understand the sources of variability affecting tDCS efficacy. Possible
suspects include the placement of the electrodes, task parameters during
stimulation, dosing (current amplitude, duration of stimulation,
frequency of stimulation), individual states (e.g., anxiety, motivation,
attention), and more. In this review, we first briefly review potential
sources of variability specific to stroke motor recovery following
tDCS. We then examine how the anatomical variability in tDCS placement
[e.g., neural target(s) and montages employed] may alter the
neuromodulatory effects that tDCS exerts on the post-stroke motor
system.
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