Research progress on the neuromodulation targets in stroke rehabilitation_Journal of Biomedical Engineering

Authors：

YANG Xuedong ¹ ,  WANG Ling ^1,2,3 ,  YANG Jiajia ^1,2,3 , ZHENG Chenguang ^1,2,3 , MING Dong ^1,2,3

1. Medical School, Tianjin University, Tianjin 300072, P. R. China;
2. Haihe Laboratory of Brain-Computer Interaction and Human–Machine Integration, Tianjin 300392, P. R. China;
3. Tianjin Key Laboratory of Brain Science and Neuroengineering, Tianjin 300072, P. R. China;

Corresponding?author：

WANG Ling, Email: lwang2015@tju.edu.cn; YANG Jiajia, Email: jiajia.yang@tju.edu.cn

Keywords：

Neuromodulation; Stroke; Transcranial magnetic stimulation; Transcranial current stimulation; Transcranial ultrasound stimulation

DOI：

10.7507/1001-5515.202509066

Video：

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Abstract Full text Figures/Tables Video References Cited by

Recent years have witnessed significant advances in neuromodulation techniques for stroke rehabilitation, especially in ameliorating motor deficits, positioning them as a key focus in both research and clinical practice. The selection of stimulation targets is crucial, as different sites engage distinct neural mechanisms and yield varied therapeutic outcomes. This review systematically synthesizes evidence from neuromodulation studies that target key regions, including the cerebral hemispheres, sensorimotor cortex, cerebellum, and vagus nerve. By analyzing the stimulation protocols, therapeutic effects, and optimal parameters associated with each target, we aim to provide a theoretical foundation and practical guidance for refining neuromodulation strategies in stroke rehabilitation.

Citation： YANG Xuedong, WANG Ling, YANG Jiajia, ZHENG Chenguang, MING Dong. Research progress on the neuromodulation targets in stroke rehabilitation. Journal of Biomedical Engineering, 2026, 43(3): 615-624. doi: 10.7507/1001-5515.202509066 Copy

1.	Feigin V L, Brainin M, Norrving B, et al. World Stroke Organization: Global Stroke Fact Sheet 2025. Int J Stroke, 2025, 20(2): 132-144.
2.	《中國腦卒中防治報告2021》編寫組. 《中國腦卒中防治報告2021》概要. 中國腦血管病雜志, 2023, 20(11): 783-793.
3.	Lüdemann-Podubecká J, B?sl K, Nowak D A. Repetitive transcranial magnetic stimulation for motor recovery of the upper limb after stroke. Prog Brain Res, 2015, 218: 281-311.
4.	Du J, Yang F, Hu J, et al. Effects of high- and low-frequency repetitive transcranial magnetic stimulation on motor recovery in early stroke patients: evidence from a randomized controlled trial with clinical, neurophysiological and functional imaging assessments. Neuroimage Clin, 2019, 21: 101620.
5.	Luo J, Feng Y, Hong Z, et al. High-frequency repetitive transcranial magnetic stimulation promotes neural stem cell proliferation after ischemic stroke. Neural Regen Res, 2024, 19(8): 1772-1780.
6.	Luo L, Liu M, Fan Y, et al. Intermittent theta-burst stimulation improves motor function by inhibiting neuronal pyroptosis and regulating microglial polarization via TLR4/NFκB/NLRP3 signaling pathway in cerebral ischemic mice. J Neuroinflammation, 2022, 19(1): 141.
7.	Zong X, Gu J, Zhou S, et al. Continuous theta-burst stimulation enhances and sustains neurogenesis following ischemic stroke. Theranostics, 2022, 12(13): 5710-5726.
8.	Longo V, Barbati S A, Re A, et al. Transcranial direct current stimulation enhances neuroplasticity and accelerates motor recovery in a stroke mouse model. Stroke, 2022, 53(5): 1746-1758.
9.	Deng L D, Qi L, Suo Q, et al. Transcranial focused ultrasound stimulation reduces vasogenic edema after middle cerebral artery occlusion in mice. Neural Regen Res, 2022, 17(9): 2058-2063.
10.	Liao W W, Lin C Y, Horng Y S, et al. Transcranial direct current stimulation over the motor and premotor cortex with mirror therapy improves motor control, muscle function, and brain activity in chronic stroke: a double-blind randomized sham-controlled trial. J Neuroeng Rehabil, 2025, 22(1): 98.
11.	Xie G, Wang T, Deng L, et al. Repetitive transcranial magnetic stimulation for motor function in stroke: a systematic review and meta-analysis of randomized controlled studies. Syst Rev, 2025, 14(1): 47.
12.	Marchiotto F, Cambiaghi M, Buffelli M. Physical activity and anodal-transcranial direct current stimulation: a synergistic approach to boost motor cortex plasticity. Brain Commun, 2025, 7(3): fcaf167.
13.	Lee S H, Lee G, Kim J, et al. Resting-state hemodynamic changes and effects on upper limb function after multi-channel transcranial direct current stimulation to the ipsilesional primary motor cortex and anterior intraparietal sulcus in stroke patients: an fNIRS pilot study. J Neuroeng Rehabil, 2025, 22(1): 83.
14.	Sharif H, Alexander H, Azam A, et al. Dual motor cortex and spinal cord neuromodulation improves rehabilitation efficacy and restores skilled locomotor function in a rat cervical contusion injury model. Exp Neurol, 2021, 341: 113715.
15.	Luk K Y, Ouyang H X, Pang M Y C. Low-frequency rTMS over contralesional M1 increases ipsilesional cortical excitability and motor function with decreased interhemispheric asymmetry in subacute stroke: a randomized controlled study. Neural Plast, 2022, 2022: 3815357.
16.	Hensel L, Lange F, Tscherpel C, et al. Recovered grasping performance after stroke depends on interhemispheric frontoparietal connectivity. Brain, 2023, 146(3): 1006-1020.
17.	潘旗開, 劉獻松, 吳泳锫. 間歇性Theta節律刺激聯合床旁康復訓練治療在急性重癥腦卒中患者上肢運動障礙恢復中的應用. 實用醫院臨床雜志, 2024, 21(4): 63-67.
18.	Garrido M M, álvarez E E, Acevedo P F, et al. Early transcranial direct current stimulation with modified constraint-induced movement therapy for motor and functional upper limb recovery in hospitalized patients with stroke: a randomized, multicentre, double-blind, clinical trial. Brain Stimul, 2023, 16(1): 40-47.
19.	Wang W J, Zhong Y B, Zhao J J, et al. Transcranial pulse current stimulation improves the locomotor function in a rat model of stroke. Neural Regen Res, 2021, 16(7): 1229-1234.
20.	Xia X, Wang Z, Zeng K, et al. Effects of the motor cortical theta-burst transcranial-focused ultrasound stimulation on the contralateral motor cortex. J Physiol, 2024, 602(12): 2931-2943.
21.	Zhang T, Guo B, Zuo Z, et al. Excitatory-inhibitory modulation of transcranial focus ultrasound stimulation on human motor cortex. CNS Neurosci Ther, 2023, 29(12): 3829-3841.
22.	Wang J, Li G, Deng L, et al. Transcranial focused ultrasound stimulation improves neurorehabilitation after middle cerebral artery occlusion in mice. Aging Dis, 2021, 12(1): 50-60.
23.	Li H, Sun J, Zhang D, et al. Low-intensity (400 mW/cm², 500 kHz) pulsed transcranial ultrasound preconditioning may mitigate focal cerebral ischemia in rats. Brain Stimul, 2017, 10(3): 695-702.
24.	Buetefisch C M, Wei L, Gu X, et al. Neuroprotection of low-frequency repetitive transcranial magnetic stimulation after ischemic stroke in rats. Ann Neurol, 2023, 93(2): 336-347.
25.	Liao L Y, Xie Y J, Chen Y, et al. Cerebellar theta-burst stimulation combined with physiotherapy in subacute and chronic stroke patients: a pilot randomized controlled trial. Neurorehabil Neural Repair, 2021, 35(1): 23-32.
26.	Liao L Y, Zhu Y, Peng Q Y, et al. Intermittent theta-burst stimulation for stroke: primary motor cortex versus cerebellar stimulation: a randomized sham-controlled trial. Stroke, 2024, 55(1): 156-165.
27.	Rosso C, Moulton E J, Kemlin C, et al. Cerebello-motor paired associative stimulation and motor recovery in stroke: a randomized, sham-controlled, double-blind pilot trial. Neurotherapeutics, 2022, 19(2): 491-500.
28.	Qurat Ul A, Ahmad Z, Ilyas S, et al. Comparison of a single session of tDCS on cerebellum vs. motor cortex in stroke patients: a randomized sham-controlled trial. Ann Med, 2023, 55(2): 2252439.
29.	Abbasi A, Danielsen N P, Leung J, et al. Epidural cerebellar stimulation drives widespread neural synchrony in the intact and stroke perilesional cortex. J Neuroeng Rehabil, 2021, 18(1): 89.
30.	Gopalakrishnan R, Cunningham D A, Hogue O, et al. Electrophysiological correlates of dentate nucleus deep brain stimulation for poststroke motor recovery. J Neurosci, 2024, 44(27): e1357242024.
31.	Li X, Baker K B, O’laughlin K, et al. Paired DBS and TMS reveals dentato-cortical facilitation underlying upper extremity movement in chronic stroke survivors. Neurorehabil Neural Repair, 2024, 38(2): 109-121.
32.	Li X, Baker K B, O’laughlin K, et al. Acute dentate nucleus deep brain stimulation modulates corticomotor excitability in chronic stroke survivors. Brain Stimul, 2025, 18(3): 640-648.
33.	Baker K B, Plow E B, Nagel S, et al. Cerebellar deep brain stimulation for chronic post-stroke motor rehabilitation: a phase I trial. Nat Med, 2023, 29(9): 2366-2374.
34.	Cajigas I, Morrison M A, Luciano M S, et al. Cerebellar deep brain stimulation for the treatment of movement disorders in cerebral palsy. J Neurosurg, 2023, 139(3): 605-614.
35.	Baek H, Sariev A, Lee S, et al. Deep cerebellar low-intensity focused ultrasound stimulation restores interhemispheric balance after ischemic stroke in mice. IEEE Trans Neural Syst Rehabil Eng, 2020, 28(9): 2073-2079.
36.	Baek H, Pahk K J, Kim M J, et al. Modulation of cerebellar cortical plasticity using low-intensity focused ultrasound for poststroke sensorimotor function recovery. Neurorehabil Neural Repair, 2018, 32(9): 777-787.
37.	Chan H H, Cooperrider J, Chen Z, et al. Lateral cerebellar nucleus stimulation has selective effects on glutamatergic and GABAergic perilesional neurogenesis after cortical ischemia in the rodent model. Neurosurgery, 2018, 83(5): 1057-1067.
38.	Pendharkar A V, Smerin D, Gonzalez L, et al. Optogenetic stimulation reduces neuronal nitric oxide synthase expression after stroke. Transl Stroke Res, 2021, 12(2): 347-356.
39.	Andalib S, Divani A A, Ayata C, et al. Vagus nerve stimulation in ischemic stroke. Curr Neurol Neurosci Rep, 2023, 23(12): 947-962.
40.	Tang H, Wen J, Wang L, et al. Vagus nerve stimulation inhibits PANoptosis and promotes neurofunctional recovery of cerebral ischemic stroke in a Sirt1-dependent manner. Neurochem Int, 2025, 184: 105950.
41.	Wen J, Tang H, Wang L, et al. Vagus nerve stimulation inhibits pyroptosis and improves outcome of cerebral ischemic stroke by upregulating osteopontin (SPP1) to disturb ASC oligomerization. BMC Med, 2025, 23(1): 407.
42.	Kalagara R, Chennareddy S, Reford E, et al. Complications of implanted vagus nerve stimulation: a systematic review and meta-analysis. Cerebrovasc Dis, 2025, 54(1): 112-120.
43.	Dawson J, Liu C Y, Francisco G E, et al. Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial. Lancet, 2021, 397(10284): 1545-1553.
44.	Dawson J, Engineer N D, Cramer S C, et al. Vagus nerve stimulation paired with rehabilitation for upper limb motor impairment and function after chronic ischemic stroke: subgroup analysis of the randomized, blinded, pivotal, VNS-REHAB device trial. Neurorehabil Neural Repair, 2023, 37(6): 367-373.
45.	Xie C, Gao X, Liu G, et al. USP10 is a potential mediator for vagus nerve stimulation to alleviate neuroinflammation in ischaemic stroke by inhibiting NF-κB signalling pathway. Front Immunol, 2023, 14: 1130697.
46.	Ay I, Nasser R, Simon B, et al. Transcutaneous cervical vagus nerve stimulation ameliorates acute ischemic injury in rats. Brain Stimul, 2016, 9(2): 166-173.
47.	Badran B W, Peng X, Baker-Vogel B, et al. Motor activated auricular vagus nerve stimulation as a potential neuromodulation approach for post-stroke motor rehabilitation: a pilot study. Neurorehabil Neural Repair, 2023, 37(6): 374-383.
48.	Xia X M, Duan Y, Wang Y P, et al. Vagus nerve stimulation as a promising neuroprotection for ischemic stroke via α7nAchR-dependent inactivation of microglial NLRP3 inflammasome. Acta Pharmacol Sin, 2024, 45(7): 1349-1365.
49.	Gao Y, Zhu Y, Lu X, et al. Vagus nerve stimulation paired with rehabilitation for motor function, mental health and activities of daily living after stroke: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry, 2023, 94(4): 257-266.
50.	Morrison R A, Hulsey D R, Adcock K S, et al. Vagus nerve stimulation intensity influences motor cortex plasticity. Brain Stimul, 2019, 12(2): 256-262.
51.	Hays S A, Rennaker R L 2nd, Kilgard M P. How to fail with paired VNS therapy. Brain Stimul, 2023, 16(5): 1252-1258.
52.	He S, Baig F, Merla A, et al. Beta-triggered adaptive deep brain stimulation during reaching movement in Parkinson’s disease. Brain, 2023, 146(12): 5015-5030.
53.	Xu Z, Duan W, Yuan S, et al. Deep brain stimulation alleviates Parkinsonian motor deficits through desynchronizing GABA release in mice. Nat Commun, 2025, 16(1): 3726.
54.	Rigon L, Bove F, Izzo A, et al. Concordance between imaging and clinical based STN-DBS programming improves motor outcomes of directional stimulation in Parkinson's disease. J Parkinsons Dis, 2025, 15(2): 409-420.
55.	Kr?mer S D, Schuhmann M K, Volkmann J, et al. Deep brain stimulation in the subthalamic nucleus can improve skilled forelimb movements and retune dynamics of striatal networks in a rat stroke model. Int J Mol Sci, 2022, 23(24): 15524.
56.	Serra G P, Guillaumin A, Vlcek B, et al. A role for the subthalamic nucleus in aversive learning. Cell Rep, 2023, 42(11): 113328.
57.	Dirisio A C, Avecillas-Chasin J M, Platt S, et al. White matter connectivity of subthalamic nucleus and globus pallidus interna targets for deep brain stimulation. J Neurosurg, 2023, 139(5): 1366-1375.
58.	Dostrovsky J O, Hutchison W D, Lozano A M. The globus pallidus, deep brain stimulation, and Parkinson's disease. Neuroscientist, 2002, 8(3): 284-290.
59.	Liu J, Ding H, Xu K, et al. Pallidal versus subthalamic deep-brain stimulation for meige syndrome: a retrospective study. Sci Rep, 2021, 11(1): 8742.
60.	Shanker V. Essential tremor: diagnosis and management. BMJ, 2019, 366: l4485.
61.	Milosevic L, Kalia S K, Hodaie M, et al. Physiological mechanisms of thalamic ventral intermediate nucleus stimulation for tremor suppression. Brain, 2018, 141(7): 2142-2155.
62.	Paro M R, Dyrda M, Ramanan S, et al. Deep brain stimulation for movement disorders after stroke: a systematic review of the literature. J Neurosurg, 2023, 138(6): 1688-1701.
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1. Feigin V L, Brainin M, Norrving B, et al. World Stroke Organization: Global Stroke Fact Sheet 2025. Int J Stroke, 2025, 20(2): 132-144.
2. 《中國腦卒中防治報告2021》編寫組. 《中國腦卒中防治報告2021》概要. 中國腦血管病雜志, 2023, 20(11): 783-793.
3. Lüdemann-Podubecká J, B?sl K, Nowak D A. Repetitive transcranial magnetic stimulation for motor recovery of the upper limb after stroke. Prog Brain Res, 2015, 218: 281-311.
4. Du J, Yang F, Hu J, et al. Effects of high- and low-frequency repetitive transcranial magnetic stimulation on motor recovery in early stroke patients: evidence from a randomized controlled trial with clinical, neurophysiological and functional imaging assessments. Neuroimage Clin, 2019, 21: 101620.
5. Luo J, Feng Y, Hong Z, et al. High-frequency repetitive transcranial magnetic stimulation promotes neural stem cell proliferation after ischemic stroke. Neural Regen Res, 2024, 19(8): 1772-1780.
6. Luo L, Liu M, Fan Y, et al. Intermittent theta-burst stimulation improves motor function by inhibiting neuronal pyroptosis and regulating microglial polarization via TLR4/NFκB/NLRP3 signaling pathway in cerebral ischemic mice. J Neuroinflammation, 2022, 19(1): 141.
7. Zong X, Gu J, Zhou S, et al. Continuous theta-burst stimulation enhances and sustains neurogenesis following ischemic stroke. Theranostics, 2022, 12(13): 5710-5726.
8. Longo V, Barbati S A, Re A, et al. Transcranial direct current stimulation enhances neuroplasticity and accelerates motor recovery in a stroke mouse model. Stroke, 2022, 53(5): 1746-1758.
9. Deng L D, Qi L, Suo Q, et al. Transcranial focused ultrasound stimulation reduces vasogenic edema after middle cerebral artery occlusion in mice. Neural Regen Res, 2022, 17(9): 2058-2063.
10. Liao W W, Lin C Y, Horng Y S, et al. Transcranial direct current stimulation over the motor and premotor cortex with mirror therapy improves motor control, muscle function, and brain activity in chronic stroke: a double-blind randomized sham-controlled trial. J Neuroeng Rehabil, 2025, 22(1): 98.
11. Xie G, Wang T, Deng L, et al. Repetitive transcranial magnetic stimulation for motor function in stroke: a systematic review and meta-analysis of randomized controlled studies. Syst Rev, 2025, 14(1): 47.
12. Marchiotto F, Cambiaghi M, Buffelli M. Physical activity and anodal-transcranial direct current stimulation: a synergistic approach to boost motor cortex plasticity. Brain Commun, 2025, 7(3): fcaf167.
13. Lee S H, Lee G, Kim J, et al. Resting-state hemodynamic changes and effects on upper limb function after multi-channel transcranial direct current stimulation to the ipsilesional primary motor cortex and anterior intraparietal sulcus in stroke patients: an fNIRS pilot study. J Neuroeng Rehabil, 2025, 22(1): 83.
14. Sharif H, Alexander H, Azam A, et al. Dual motor cortex and spinal cord neuromodulation improves rehabilitation efficacy and restores skilled locomotor function in a rat cervical contusion injury model. Exp Neurol, 2021, 341: 113715.
15. Luk K Y, Ouyang H X, Pang M Y C. Low-frequency rTMS over contralesional M1 increases ipsilesional cortical excitability and motor function with decreased interhemispheric asymmetry in subacute stroke: a randomized controlled study. Neural Plast, 2022, 2022: 3815357.
16. Hensel L, Lange F, Tscherpel C, et al. Recovered grasping performance after stroke depends on interhemispheric frontoparietal connectivity. Brain, 2023, 146(3): 1006-1020.
17. 潘旗開, 劉獻松, 吳泳锫. 間歇性Theta節律刺激聯合床旁康復訓練治療在急性重癥腦卒中患者上肢運動障礙恢復中的應用. 實用醫院臨床雜志, 2024, 21(4): 63-67.
18. Garrido M M, álvarez E E, Acevedo P F, et al. Early transcranial direct current stimulation with modified constraint-induced movement therapy for motor and functional upper limb recovery in hospitalized patients with stroke: a randomized, multicentre, double-blind, clinical trial. Brain Stimul, 2023, 16(1): 40-47.
19. Wang W J, Zhong Y B, Zhao J J, et al. Transcranial pulse current stimulation improves the locomotor function in a rat model of stroke. Neural Regen Res, 2021, 16(7): 1229-1234.
20. Xia X, Wang Z, Zeng K, et al. Effects of the motor cortical theta-burst transcranial-focused ultrasound stimulation on the contralateral motor cortex. J Physiol, 2024, 602(12): 2931-2943.
21. Zhang T, Guo B, Zuo Z, et al. Excitatory-inhibitory modulation of transcranial focus ultrasound stimulation on human motor cortex. CNS Neurosci Ther, 2023, 29(12): 3829-3841.
22. Wang J, Li G, Deng L, et al. Transcranial focused ultrasound stimulation improves neurorehabilitation after middle cerebral artery occlusion in mice. Aging Dis, 2021, 12(1): 50-60.
23. Li H, Sun J, Zhang D, et al. Low-intensity (400 mW/cm², 500 kHz) pulsed transcranial ultrasound preconditioning may mitigate focal cerebral ischemia in rats. Brain Stimul, 2017, 10(3): 695-702.
24. Buetefisch C M, Wei L, Gu X, et al. Neuroprotection of low-frequency repetitive transcranial magnetic stimulation after ischemic stroke in rats. Ann Neurol, 2023, 93(2): 336-347.
25. Liao L Y, Xie Y J, Chen Y, et al. Cerebellar theta-burst stimulation combined with physiotherapy in subacute and chronic stroke patients: a pilot randomized controlled trial. Neurorehabil Neural Repair, 2021, 35(1): 23-32.
26. Liao L Y, Zhu Y, Peng Q Y, et al. Intermittent theta-burst stimulation for stroke: primary motor cortex versus cerebellar stimulation: a randomized sham-controlled trial. Stroke, 2024, 55(1): 156-165.
27. Rosso C, Moulton E J, Kemlin C, et al. Cerebello-motor paired associative stimulation and motor recovery in stroke: a randomized, sham-controlled, double-blind pilot trial. Neurotherapeutics, 2022, 19(2): 491-500.
28. Qurat Ul A, Ahmad Z, Ilyas S, et al. Comparison of a single session of tDCS on cerebellum vs. motor cortex in stroke patients: a randomized sham-controlled trial. Ann Med, 2023, 55(2): 2252439.
29. Abbasi A, Danielsen N P, Leung J, et al. Epidural cerebellar stimulation drives widespread neural synchrony in the intact and stroke perilesional cortex. J Neuroeng Rehabil, 2021, 18(1): 89.
30. Gopalakrishnan R, Cunningham D A, Hogue O, et al. Electrophysiological correlates of dentate nucleus deep brain stimulation for poststroke motor recovery. J Neurosci, 2024, 44(27): e1357242024.
31. Li X, Baker K B, O’laughlin K, et al. Paired DBS and TMS reveals dentato-cortical facilitation underlying upper extremity movement in chronic stroke survivors. Neurorehabil Neural Repair, 2024, 38(2): 109-121.
32. Li X, Baker K B, O’laughlin K, et al. Acute dentate nucleus deep brain stimulation modulates corticomotor excitability in chronic stroke survivors. Brain Stimul, 2025, 18(3): 640-648.
33. Baker K B, Plow E B, Nagel S, et al. Cerebellar deep brain stimulation for chronic post-stroke motor rehabilitation: a phase I trial. Nat Med, 2023, 29(9): 2366-2374.
34. Cajigas I, Morrison M A, Luciano M S, et al. Cerebellar deep brain stimulation for the treatment of movement disorders in cerebral palsy. J Neurosurg, 2023, 139(3): 605-614.
35. Baek H, Sariev A, Lee S, et al. Deep cerebellar low-intensity focused ultrasound stimulation restores interhemispheric balance after ischemic stroke in mice. IEEE Trans Neural Syst Rehabil Eng, 2020, 28(9): 2073-2079.
36. Baek H, Pahk K J, Kim M J, et al. Modulation of cerebellar cortical plasticity using low-intensity focused ultrasound for poststroke sensorimotor function recovery. Neurorehabil Neural Repair, 2018, 32(9): 777-787.
37. Chan H H, Cooperrider J, Chen Z, et al. Lateral cerebellar nucleus stimulation has selective effects on glutamatergic and GABAergic perilesional neurogenesis after cortical ischemia in the rodent model. Neurosurgery, 2018, 83(5): 1057-1067.
38. Pendharkar A V, Smerin D, Gonzalez L, et al. Optogenetic stimulation reduces neuronal nitric oxide synthase expression after stroke. Transl Stroke Res, 2021, 12(2): 347-356.
39. Andalib S, Divani A A, Ayata C, et al. Vagus nerve stimulation in ischemic stroke. Curr Neurol Neurosci Rep, 2023, 23(12): 947-962.
40. Tang H, Wen J, Wang L, et al. Vagus nerve stimulation inhibits PANoptosis and promotes neurofunctional recovery of cerebral ischemic stroke in a Sirt1-dependent manner. Neurochem Int, 2025, 184: 105950.
41. Wen J, Tang H, Wang L, et al. Vagus nerve stimulation inhibits pyroptosis and improves outcome of cerebral ischemic stroke by upregulating osteopontin (SPP1) to disturb ASC oligomerization. BMC Med, 2025, 23(1): 407.
42. Kalagara R, Chennareddy S, Reford E, et al. Complications of implanted vagus nerve stimulation: a systematic review and meta-analysis. Cerebrovasc Dis, 2025, 54(1): 112-120.
43. Dawson J, Liu C Y, Francisco G E, et al. Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial. Lancet, 2021, 397(10284): 1545-1553.
44. Dawson J, Engineer N D, Cramer S C, et al. Vagus nerve stimulation paired with rehabilitation for upper limb motor impairment and function after chronic ischemic stroke: subgroup analysis of the randomized, blinded, pivotal, VNS-REHAB device trial. Neurorehabil Neural Repair, 2023, 37(6): 367-373.
45. Xie C, Gao X, Liu G, et al. USP10 is a potential mediator for vagus nerve stimulation to alleviate neuroinflammation in ischaemic stroke by inhibiting NF-κB signalling pathway. Front Immunol, 2023, 14: 1130697.
46. Ay I, Nasser R, Simon B, et al. Transcutaneous cervical vagus nerve stimulation ameliorates acute ischemic injury in rats. Brain Stimul, 2016, 9(2): 166-173.
47. Badran B W, Peng X, Baker-Vogel B, et al. Motor activated auricular vagus nerve stimulation as a potential neuromodulation approach for post-stroke motor rehabilitation: a pilot study. Neurorehabil Neural Repair, 2023, 37(6): 374-383.
48. Xia X M, Duan Y, Wang Y P, et al. Vagus nerve stimulation as a promising neuroprotection for ischemic stroke via α7nAchR-dependent inactivation of microglial NLRP3 inflammasome. Acta Pharmacol Sin, 2024, 45(7): 1349-1365.
49. Gao Y, Zhu Y, Lu X, et al. Vagus nerve stimulation paired with rehabilitation for motor function, mental health and activities of daily living after stroke: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry, 2023, 94(4): 257-266.
50. Morrison R A, Hulsey D R, Adcock K S, et al. Vagus nerve stimulation intensity influences motor cortex plasticity. Brain Stimul, 2019, 12(2): 256-262.
51. Hays S A, Rennaker R L 2nd, Kilgard M P. How to fail with paired VNS therapy. Brain Stimul, 2023, 16(5): 1252-1258.
52. He S, Baig F, Merla A, et al. Beta-triggered adaptive deep brain stimulation during reaching movement in Parkinson’s disease. Brain, 2023, 146(12): 5015-5030.
53. Xu Z, Duan W, Yuan S, et al. Deep brain stimulation alleviates Parkinsonian motor deficits through desynchronizing GABA release in mice. Nat Commun, 2025, 16(1): 3726.
54. Rigon L, Bove F, Izzo A, et al. Concordance between imaging and clinical based STN-DBS programming improves motor outcomes of directional stimulation in Parkinson's disease. J Parkinsons Dis, 2025, 15(2): 409-420.
55. Kr?mer S D, Schuhmann M K, Volkmann J, et al. Deep brain stimulation in the subthalamic nucleus can improve skilled forelimb movements and retune dynamics of striatal networks in a rat stroke model. Int J Mol Sci, 2022, 23(24): 15524.
56. Serra G P, Guillaumin A, Vlcek B, et al. A role for the subthalamic nucleus in aversive learning. Cell Rep, 2023, 42(11): 113328.
57. Dirisio A C, Avecillas-Chasin J M, Platt S, et al. White matter connectivity of subthalamic nucleus and globus pallidus interna targets for deep brain stimulation. J Neurosurg, 2023, 139(5): 1366-1375.
58. Dostrovsky J O, Hutchison W D, Lozano A M. The globus pallidus, deep brain stimulation, and Parkinson's disease. Neuroscientist, 2002, 8(3): 284-290.
59. Liu J, Ding H, Xu K, et al. Pallidal versus subthalamic deep-brain stimulation for meige syndrome: a retrospective study. Sci Rep, 2021, 11(1): 8742.
60. Shanker V. Essential tremor: diagnosis and management. BMJ, 2019, 366: l4485.
61. Milosevic L, Kalia S K, Hodaie M, et al. Physiological mechanisms of thalamic ventral intermediate nucleus stimulation for tremor suppression. Brain, 2018, 141(7): 2142-2155.
62. Paro M R, Dyrda M, Ramanan S, et al. Deep brain stimulation for movement disorders after stroke: a systematic review of the literature. J Neurosurg, 2023, 138(6): 1688-1701.
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Research progress on the neuromodulation targets in stroke rehabilitation

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