Clinical NIBS applications
Noninvasive brain stimulation (NIBS) is capable of manipulating neural activity and network excitability during and beyond the stimulation protocol. This gives rise to its clinical application in various psychiatric, neurological and rehabilitation settings. Our first and most direct clinical application is related to neglect rehabilitation after stroke. It is important to realize that the spontaneous functional reorganization in stroke patients is often maladaptive.
We intend to use NIBS (TMS/TDCS) to suppress / activate different parts within the reorganised activation network in order to restore a more healthy balance between hemispheres and thereby promote behavioural recovery. We will systematically exploit our basic brain research findings in order to initiate, guide, and support brain recovery in stroke and neglect patients, developing a new and powerful tool for the rehabilitative armamentarium. Existing fragmentary evidence indicates that our approach of manipulating brain plasticity (block it when it is maladaptive, stimulate it when it is adaptive) will be highly successful, and offers a realistic perspective for extension to other neurological populations, including amputation or Parkinson patients.
Another clinical application of NIBS that we are investigating is related to Alzheimer’s disease. More specifically, we want to examine the potential of rhythmic brain stimulation (rTMS/tACS) in modulating frontoparietal attention networks in prodromal Alzheimer’s diesase to beneficially modify cognitive symptoms and interfere with disease progression. In our investigations, we focus on mechanisms in frontoparietal attention networks that support working memory performance, and we are currently conducting fMRI studies to explore these mechanisms in healthy controls and patients (see also our research line on Visual Learning & Memory).
Furthermore, we combine NIBS with electromyography (EMG) and electroencephalography (EEG) to characterize aberrant cortical brain plasticity in patient groups. Our aim is to advance our understanding of the neurobiological substrate of neurodegenerative brain processes in Alzheimer’s disease and in diabetes mellitus. Transcranial magnetic stimulation-based measures of cortical plasticity can provide an objective assessment of central nervous system malfunctioning. Eventually, our goal is to develop a reliable assay for an early detection and longitudinal assessment of adverse cortical brain consequences, such as impaired cognitive function, an increase in age-related cognitive decline, and an increased risk of dementia. These measures can eventually serve as early biomarkers for cognitive dysfunctions. Moreover, they can inform about the development and effectiveness of therapies and assess treatment responses in clinical trials.
- Prof. dr. Alexander T. Sack
- Dr. Teresa Schuhmann
- MSc. Helen Mayerhofer
- MSc. Lukas Schilberg