Stroke is a leading cause of long-term disability, with motor impairments, particularly in the upper extremities, significantly impacting the quality of life for survivors. While rehabilitation approaches have made progress, recovery outcomes remain variable, highlighting the need for more personalized therapeutic strategies. Non-invasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS) and transcranial electric stimulation (tES), offer promising adjuncts to conventional rehabilitation, particularly by modulating neural plasticity and promoting functional reorganization.
his presentation will focus on the development and application of personalized NIBS strategies tailored to individual stroke patients, aiming to optimize motor recovery (Coscia et al. 2019; Micera et al. 2020). Key factors influencing response variability, such as lesion characteristics, time post-stroke, and individual neurophysiological profiles, will be discussed. We will present recent findings from clinical trials and translational research, demonstrating how patient-specific parameters can guide the customization of stimulation protocols. This includes selecting the appropriate stimulation intensity, frequency, and target brain regions based on clinical, neuroimaging and neurophysiological assessments.
Furthermore, the integration of NIBS with neurorehabilitation paradigms as a synergistic approach to enhance recovery and novel NIBS strategies that extend the opportunities towards deep brain structures such as focused ultrasound will be highlighted and critically discussed. Personalized NIBS has shown potential to maximize treatment efficacy by adapting interventional strategies to the individual neuroplastic capacities and network characteristics of stroke survivors.
By advancing toward precision neurorehabilitation, personalized NIBS strategies hold the promise of improving neurorehabilitation outcomes, minimizing variability in treatment response, and ultimately enhancing the functional outcome and its impact on quality of life for stroke patients.
