Work

Potential Locations for Noninvasive Brain Stimulation in Treating Poststroke Deficits: Exploration From Multimodal Neuroimaging

Year: 2026

Type: review

Abstract: AIMS: Noninvasive brain stimulation (NIBS) shows promise for poststroke deficits (PSDs), but efficacy may be limited by inconsistent stimulation sites. METHODS: By integrating neuroimaging meta-analysis, lesion-symptom mapping (LSM), and resting-state functional connectivity (FC) analysis, we employed three analytical pipelines to explore potential NIBS targets for alexia, aphasia, apraxia, ataxia, dysarthria, hemiplegia, paresthesia, and dysphagia. Pipeline 1 identified cortical regions directly associated with each PSD via coordinate-based meta-analysis using Neurosynth Compose. Pipeline 2 identified cortical regions exhibiting maximal functional connectivity with neurosynth-derived regions of interest (ROI). Pipeline 3 identified cortical regions functionally connected to ROIs from a prior large-scale LSM study. During Pipeline 2 and 3, ROIs were used for seed-to-voxel FC analysis using resting-state fMRI data from 100 healthy subjects. Identified cortical targets were mapped onto the scalp and referenced by the 10-20 system and continuous proportional coordinates. RESULTS: Potential cortical targets and scalp locations were identified for all eight PSDs. For instance, for hemiplegia, validated targets included primary motor and somatosensory cortices and supplementary motor area; novel targets included angular gyrus, superior frontal gyrus, inferior parietal lobule, medial prefrontal cortex, and precuneus. CONCLUSIONS: This multimodal approach systematically identified precise NIBS targets, confirming established sites and revealing novel regions to broaden neuromodulation strategies for poststroke recovery.

Source: CNS Neuroscience & Therapeutics

DOI: 10.1002/cns.71229