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Transcranial Magnetic Stimulation for the Prediction and Enhancement of Rehabilitation Treatment Effects

Harris-Love, Michelle PT, PhD

Journal of Neurologic Physical Therapy: June 2012 - Volume 36 - Issue 2 - p 87–93
doi: 10.1097/NPT.0b013e3182564d26
Special Interest Articles

In this update on rehabilitation technology, transcranial magnetic stimulation (TMS), a technique that allows noninvasive stimulation of the brain, is examined. The background and basic principles of TMS are reviewed, and its usefulness as a tool to inform and possibly augment the rehabilitation process is discussed. The three main paradigms by which TMS is applied—physiological measurement, disruption/virtual lesion studies, and modulation of cortical excitability—are discussed relative to the types of scientific information each paradigm can provide and their potential clinical usefulness in the future. One of the more exciting prospects is that, when combined with rehabilitation training, TMS modulation of cortical excitability could potentially enhance the effects of rehabilitation and lead to greater levels of recovery than are currently attainable with rehabilitation alone. It is concluded that current studies must focus on the mechanisms of recovery based on the specific structures and processes affected by the disorder and the neural effects of specific rehabilitation interventions in order for the potential of TMS-augmented rehabilitation to be realized.

Rehabilitation Medicine & Interdisciplinary Program in Neuroscience, Medstar National Rehabilitation Hospital, Georgetown University, Washington, District of Columbia.

Correspondence: Michelle Harris-Love, PT, PhD, Medstar National Rehabilitation Hospital, 102 Irving Street NW, Washington, DC 20010; E-mail: mh672@georgetown.edu.

The author declares no conflict of interest.

© 2012 Neurology Section, APTA