Neurorehabilitation for upper limb recovery after stroke : The use of non-invasive brain stimulation

Abstract

Although the treatment options for a stroke (cerebral infarction or cerebral haemorrhage) have greatly improved in recent years, about half of the patients suffer from reduced arm function in the long term. The impact on daily functioning is often significant. Unfortunately, there are currently no effective rehabilitation treatments that can promote the ability of the brain to recover and improve the motor function of the affected arm.

Knowledge of the recovery of arm function after a stroke is important for the development of new rehabilitation (recovery-promoting) treatments. This thesis focuses on the value of various outcome measures of arm function in patients and in animal models, and emphasizes the importance of standardized times and sets of outcome measures, including self-reports.

The thesis also focuses on the use of non-invasive brain stimulation, a promising method for promoting recovery during the rehabilitation process. The research described in this thesis suggests that the timing of treatment onset after stroke is decisive for the outcome. An early start of brain stimulation (within one month) appears to increase the chance of improving arm function. It also appears that patients undergoing brain stimulation treatment experience this as pleasant, comfortable and effective. These experiences can contribute to the development and implementation of brain stimulation in clinical practice.