Deans' stroke musings: Advancing Post‐Stroke Rehabilitation: Emerging and Current Neuromodulation Approaches and Integration of Artificial Intelligence‐Driven Closed‐Loop Systems

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, April 6, 2025

Advancing Post‐Stroke Rehabilitation: Emerging and Current Neuromodulation Approaches and Integration of Artificial Intelligence‐Driven Closed‐Loop Systems

AI is almost completely worthless until the underlying research for 100% recovery is there!

Advancing Post‐Stroke Rehabilitation: Emerging and Current Neuromodulation Approaches and Integration of Artificial Intelligence‐Driven Closed‐Loop Systems

Sensory Neuroscience

- PERSPECTIVEOPEN ACCESS

Advancing Post‐Stroke Rehabilitation: Emerging and Current Neuromodulation Approaches and Integration of Artificial Intelligence‐Driven Closed‐Loop Systems

Tiago Cunha Reis1 | Ana Machado2

1Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal | 2Champalimaud Neuroscience Programme, Champalimaud Centre for the Unknown,

Lisbon, Portugal

Correspondence: Tiago Cunha Reis (reis.tiago@edu.ulisboa.pt)

Received: 6 January 2025 | Revised: 7 February 2025 | Accepted: 12 February 2025

ABSTRACT

Chronic stroke represents a significant global health burden, requiring innovative rehabilitation strategies that extend beyond conventional therapies. Neuromodulation, including transcutaneous vagus nerve stimulation, deep brain stimulation, and brain–computer interfaces, has emerged as a transformative approach, leveraging neuroplasticity to enhance motor and cognitive recovery. Integrating artificial intelligence (AI) within these modalities enables adaptive, patient‐specific interventions through real‐time feedback, predictive modeling, and advanced signal processing. This perspective article provides a comparative analysis of these neuromodulation techniques, examines clinical evidence, while also identifying AI‐centric research priorities to address current challenges.

1 | Introduction

The increasing survival rates of acute stroke patients have underscored the need for advanced rehabilitation strategies for the chronic phase of stroke [1, 2]. Traditional physical rehabilitation, while effective in promoting neuroplasticity, often yields diminishing returns after the first year post‐stroke. With a significant portion of global healthcare expenditure allocated to stroke management and an aging population driving increased incidence, innovative interventions that extend or enhance recovery trajectories are essential.

Neuromodulation, applying electromagnetic energy to modulate neural activity, has emerged as a promising adjunct to conventional therapies [3]. Both invasive and non‐invasive

modalities have demonstrated the capacity to induce synaptogenesis and functional reorganization, critical processes in post‐stroke recovery [4, 5]. Recent breakthroughs in technologies

like vagus nerve stimulation (VNS), deep brain stimulation(DBS), and brain–computer interfaces (BCIs) offer novel pathways to harness these mechanisms (Figure 1). Integrating AI into these platforms holds the potential to create adaptive, patient‐specific therapeutic systems, transforming the neuromodulation landscape