Transcranial direct current stimulation: a place in the future of physiotherapy?

Abstract

Background: Cortical plasticity underlies the brain's ability to compensate and adapt after neurological and musculoskeletal injury. However, increasing evidence demonstrates that plasticity can also be maladaptive, contributing to functional impairment in a variety of conditions. Transcranial direct current stimulation (tDCS) is an emerging brain stimulation technique with the potential to alter cortical plasticity and prime the brain to enhance learning. If the potential of this technique can be harnessed, tDCS may provide a novel therapeutic approach in physiotherapy practice.Objectives: This review aims to provide an overview of the mechanisms, stimulation parameters and clinical applications of tDCS. Major findings: tDCS is an emerging and novel technique. Evidence at this early stage is promising with reductions in pain scores and improvements in motor function noted across a range of conditions. However, further research is needed before clinical efficacy and safety can be determined. Conclusions: tDCS is a powerful, non-invasive brain stimulation technique with the potential to improve outcomes in neurological and musculoskeletal conditions. Further research is needed using large sample sizes, long-term follow-up and a range of patient populations before the technique is available for clinical use. However, tDCS may be useful as a standalone therapy or as an adjunct to other physiotherapy treatments in the future.

Network Theory and Effects of Transcranial Brain Stimulation Methods on the Brain Networks

“…Tek-uyarım TMU'da çalışılacak beyin fonksiyonuna uygun eşik değere göre belirlenen şiddette uyarım, seçilen bölgeye uygulanır. (2,(24)(25)(26)(27).…”

Electrify your brain: can a controversial technique enhance recovery of function after brain damage?

“…1,3,4 In this issue, Schabrun reviews the pertinent literature regarding the potential of tDCS to assist physical therapy in rehabilitation of motor performance of the affected hand after stroke or in Parkinson's disease and to reduce pain scores in chronic pain syndromes. 7 When the application follows the current safety guidelines tDCS appears to be a safe technique with only minor side effects. 8 As highlighted in the review by Schabrun, only a handful of quite heterogeneous studies tested the effectiveness of tDCS in small samples of patients with stroke, Parkinson's disease or chronic pain, among other disease entities.…”

A Case Study on Efficacy of Transcranial Direct Current Stimulation in Management of Migraine.

“…Inparticular, transcranial direct current stimulation is a new technique with potential to induce change in cortical networks which outlast the period of stimulation .TDCS is a non-invasive brain stimulation technique that applies a mild (1 to 2 ma) direct electrical current via the scalp to enhance or diminish neuronal excitability. There is strong evidence that neurons underlying the anode are excited with resting membrane potential shifting towards depolarization and an increased rate of spontaneous neuronal firing and the neurons underlying the cathode are inhibited with resting membrane potential shifting towards hyper polarization and reduced neuronal firing 6 .…”