Article

This narrative review aims to provide an objective view of the noninvasive
neuromodulation (NINM) protocols available for treating spasticity, including
repetitive transcranial magnetic stimulation (rTMS) and transcranial direct
current stimulation (tDCS). On the basis of the relevant randomized controlled
trials, we infer that NINM is more effective in reducing spasticity when combined
with the conventional therapies than used as a stand-alone treatment. However,
the magnitude of NINM after-effects depends significantly on the applied
hemisphere and the underlying pathology. Being in line with these arguments,
low-frequency rTMS and cathodal-tDCS over the unaffected hemisphere are more
effective in reducing spasticity than high-frequency rTMS and anodal-tDCS over
the affected hemisphere in chronic poststroke. However, most of the studies are
heterogeneous in the stimulation setup, patient selection, follow-up duration,
and the availability of the sham operation. Therefore, the available data on the
usefulness of NINM in reducing spasticity need to be confirmed by larger and
multicentric randomized controlled trials to gather evidence on the efficiency of
NINM regimens in reducing spasticity in various neurologic conditions. LEVEL OF
EVIDENCE: V.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS