Transcranial Current Stimulation in Poststroke Hand Paresis Rehabilitation
Transcranial current stimulation (TCS) is a widely studied method of noninvasive modulation of the cerebral cortex excitability recently. Induced long-term effects of stimulation and influence on the neuroplasticity processes make it possible to consider TCS as a promising tool for the rehabilitation of patients with various nervous system disorders. TCS could be applied for the restoration of hand motor function in poststroke patients. Recent clinical trials of TCS efficacy in poststroke hand paresis showed mixed results with extremely high variability, which limits the use of this method in clinical practice. Numerous studies were aimed to find this variability reasons and to offer approaches that will increase the clinical efficacy of TCS. The obtained data demonstrate the need for personification of therapy with individual patient features when choosing a protocol for stimulation. The efficacy of the method also depends on the stroke localization and terms, the severity of motor system damage, genetic factors, stimulation protocol (electrode mounting, duration of stimulation, current intensity) and other factors. Considering the physiological mechanisms of action, it seems important to determine the most effective combination of TCS with other neurorehabilitation technics for increasing therapy efficacy.