One of the main causes of disability in the world is stroke and the number of cases has increased in recent years. Stroke can leave physical, behavioral, emotional and cognitive sequelae and therefore requires a specific approach according to the clinical characteristics of each patient.
Early neurorehabilitation treatment is crucial to achieve the highest degree of recovery and the best functional prognosis, which depends, to a large extent, on the brain’s capacity for adaptation or neuroplasticity (NP) being adequately completed.
Neuromodulation techniques are a novel proposal for the treatment of brain damage, since they safely and effectively achieve a positive therapeutic response through the modulation of neurons.
What is Transcranial Electrical Stimulation?
Transcranial electrical stimulation (tDCS) is a non-invasive, safe and effective neuromodulation technique that stimulates the brain painlessly and without side effects. The goal of tDCS is to restore brain health and minimize disability, improving the prognosis of recovery in patients who have suffered a stroke.
The tDCS treatment modulates brain neuroplasticity, that is, the capacity of recovery and reorganization of neuronal connections, helping the recovery of motor, behavioral and cognitive problems suffered by patients who have suffered a stroke.
The tDCS treatment is performed through the application of small electric currents to a specific area of the brain through electrodes placed on the scalp. The current flow penetrates the cortical and subcortical layers of the cerebral cortex, producing a neuromodulatory effect that enables clinical improvement in patients who have suffered a stroke and in neurological and psychiatric pathologies.
The excitatory electrical stimulation of the injured cerebral hemisphere or inhibitory electrical stimulation of the unaffected cerebral hemisphere allows optimizing the functional brain activity, as well as achieving a recovery of the damaged brain area in a shorter time.
Thus, transcranial electrical stimulation fulfills a double objective. On the one hand, it reinforces the connectivity of neurons close to the lesion and, on the other, it prevents interference of other brain areas involved in recovery after stroke.
Neuromodulation by tDCS: safe and painless treatment
Neuromodulation treatment using tDCS is safe, painless, non-invasive and without side effects. The procedure is always performed under medical supervision, establishing a specific stimulation protocol for each patient and pathology. In each session, electrodes are placed on the patient’s head and a very low intensity electric current is applied for 20-30 minutes. The application of the sessions should be regular and repetitive. The number of sessions and their duration depend on each patient and is assessed on an individual basis.
Before starting the treatment, the medical team will perform an electroencephalogram (EEG) and a quantified EEG (QEEG), tests that allow to evaluate brain function and make an individual assessment in order to direct the brain neuromodulation treatment individualized for each patient. In addition, post-treatment monitoring of changes in brain function is possible.
There is scientific evidence that repeated tDCS sessions help in the recovery of deficits, both in the subacute and chronic stages of the disease. The patient may notice a slight tingling in the area where stimulation is applied. Less than 2% of patients may experience headache, dizziness or similar symptomatology, these effects always being transient and of very short duration.
Post-stroke rehabilitation by neuromodulation
Treatment by tDCS has a great advantage over other non-invasive brain stimulation techniques, and that is that it can be applied concomitantly with physical therapy, behavioral, motor or cognitive training. The combination of conventional rehabilitation techniques together with neuromodulatory treatment using tDCS improves patient recovery, since its neuromodulatory effects enhance the effects of conventional rehabilitation techniques.
The treatment should be carried out by a specialized multidisciplinary team that will be in charge of establishing the intervention protocol adapted to the needs of each patient and the sequelae they present.
Postictus treatment using tDCS has shown its efficacy in improving motor disorders, aphasia, dysarthria, oropharyngeal dysphagia, depression and perceptual-cognitive difficulties that appear in these patients, improving their quality of life considerably.