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


Author: Brian F Saway1, Charles Palmer2, Christopher Hughes3, Matthew Triano4, Rishishankar E Suresh5, Jordon Gilmore6, Mark George7, Steven A Kautz8, Nathan C Rowland9

Affiliation: <sup>1</sup> Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA. Electronic address: saway@musc.edu.

<sup>2</sup> Department of Psychiatry, Medical University of South Carolina, SC 29425, USA.

<sup>3</sup> Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, USA.

<sup>4</sup> Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA.

<sup>5</sup> College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.

<sup>6</sup> Department of Bioengineering, Clemson University, Clemson, SC 29634, USA.

<sup>7</sup> Department of Psychiatry, Medical University of South Carolina, SC 29425, USA; Ralph H Johnson VA Health Care System, Charleston, SC 29425, USA.

<sup>8</sup> Department of Health Science and Research, Medical University of South Carolina, SC 29425, USA; Ralph H Johnson VA Health Care System, Charleston, SC 29425, USA.

<sup>9</sup> Department of Neurosurgery, Medical University of South Carolina, SC 29425, USA; MUSC Institute for Neuroscience Discovery (MIND), Medical University of South Carolina, SC 29425, USA.
Conference/Journal: Neurotherapeutics
Date published: 2024 Feb 19
Other:
 Volume ID: 21   ,  Issue ID: 3   ,  Pages: e00337   ,  Special Notes: doi: 10.1016/j.neurot.2024.e00337.   ,  Word Count: 172  
    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.



PMID: 38377638 DOI: 10.1016/j.neurot.2024.e00337