ABSTRACT

Functional neuroimaging research has given rise to a tantalizing and provocative new viewpoint on the role of rehabilitation therapy, to wit: that neuroplastic cortical reorganization following neuropsychological insult or illness is the norm (Kim, Ko, Parrish & Kim, 2002; Warren, Crinion, Lambon Ralph & Wise, 2009), and that a necessary and sufficient condition for any effective rehabilitation intervention is that it facilitates and directs this process. Over the past decade neuroplasticity research has revolutionized rehabilitation therapy, leading to the introduction of neuroplasticity based, high-intensity interventions such as Constraint Induced Movement Therapy (Morris, Crago, Deluca, Pidikiti & Taub, 1997), and Intensive Language Action Therapy (Pulvermüller & Berthier, 2008) designed to maximize cortical reorganization through intensive massed practice. The introduction of non-invasive brain stimulation techniques into the therapy session holds promise to take these advances to the next level of learning efficiency, by directly targeting brain structures to facilitate or inhibit their activity during concurrent traditional therapy interventions, further optimizing therapy-induced cortical reorganization. Among neurostimulatory techniques, transcranial direct current stimulation (tDCS) appears to hold particular promise as a practical clinical tool for non-invasive therapeutic stimulation of brain cortex. Advantages of this method include its portability, low cost, negligible risk, and the ease which it can be delivered concurrently with traditional cognitive, motor, or psychotherapy interventions to potentiate their impact (Schlaug, Renga, & Nair, 2008).