Research progress on non-invasive brain stimulation in reshaping post-stroke motor networks_West China Medical Journal

Authors：

LIANG Yiyi ^1,2 , YIN Mingyu ³ , ZHANG Liying ³ , ZHENG Haiqing ³ ,  HU Xiquan ³ ,  HOU Xiaohui ^1,2

1. School of Sports and Health, Guangzhou Sport University, Guangzhou, Guangdong 510500, P. R. China;
2. Guangdong Key Laboratory of Human Sports Performance Science, Guangzhou, Guangdong 510500, P. R. China;
3. Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510630, P. R. China;

Corresponding?author：

HU Xiquan, Email: huxiquan@mail.sysu.edu.cn; HOU Xiaohui, Email: houxiaohuigt@163.com

Keywords：

Stroke; motor network; non-invasive brain stimulation; repetitive transcranial magnetic stimulation; transcranial direct current stimulation

DOI：

10.7507/1002-0179.202604266

Video：

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Abstract Full text Figures/Tables Video References Cited by

The transition of the residual motor network from inefficient compensation to adaptive integration serves as a crucial foundation for post-stroke motor recovery and the regulatory direction of non-invasive brain stimulation (NIBS). NIBS can modulate network relationships within and between hemispheres as well as distant brain regions through inhibitory/excitatory strategies within the disease-related plasticity window, promoting the shift from inefficient compensation to integrative recovery of the motor network. Multimodal imaging can reveal differences in network phenotypes during this process. This article explores technologies such as functional magnetic resonance imaging, functional near-infrared spectroscopy, and electroencephalography, systematically reviews the effects of transcranial direct current stimulation and repetitive transcranial magnetic stimulation on spectral power, functional connectivity, and network topology, aiming to provide a basis for personalized NIBS applications.

Citation： LIANG Yiyi, YIN Mingyu, ZHANG Liying, ZHENG Haiqing, HU Xiquan, HOU Xiaohui. Research progress on non-invasive brain stimulation in reshaping post-stroke motor networks. West China Medical Journal, 2026, 41(6): 881-889. doi: 10.7507/1002-0179.202604266 Copy

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1. 國家衛生健康委加強腦卒中防治工作減少百萬新發殘疾工程專家委員會, 吉訓明. 《2024 年中國腦卒中防治報告》概要. 首都醫科大學學報, 2025, 46(6): 947-960.
2. Dalton EJ, Jamwal R, Augoustakis L, et al. Prevalence of arm weakness, pre-stroke outcomes and other post-stroke impairments using routinely collected clinical data on an acute stroke unit. Neurorehabil Neural Repair, 2024, 38(2): 148-160.
3. Einstad MS, Saltvedt I, Lydersen S, et al. Associations between post-stroke motor and cognitive function: a cross-sectional study. BMC Geriatr, 2021, 21(1): 103.
4. Desowska A, Turner DL. Dynamics of brain connectivity after stroke. Rev Neurosci, 2019, 30(6): 605-623.
5. Murase N, Duque J, Mazzocchio R, et al. Influence of interhemispheric interactions on motor function in chronic stroke. Ann Neurol, 2004, 55(3): 400-409.
6. Di Pino G, Pellegrino G, Assenza G, et al. Modulation of brain plasticity in stroke: a novel model for neurorehabilitation. Nat Rev Neurol, 2014, 10(10): 597-608.
7. Vizioli L, Yacoub E, Lewis LD. How pushing the spatiotemporal resolution of fMRI can advance neuroscience. Prog Neurobiol, 2021, 207: 102184.
8. Huo C, Xu G, Li W, et al. A review on functional near-infrared spectroscopy and application in stroke rehabilitation. Med Nov Technol Devices, 2021, 11: 100064.
9. Marino M, Mantini D. Human brain imaging with high-density electroencephalography: Techniques and applications. J Physiol, 2026, 604(2): 783-812.
10. Sood I, Injety RJ, Farheen A, et al. Quantitative electroencephalography to assess post-stroke functional disability: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis, 2024, 33(12): 108032.
11. Hua J, Chen D, Sun Y, et al. Structural-functional connectivity coupling in motor-brain networks following acute ischemic stroke. J Neuroeng Rehabil, 2026: 7.
12. Du J, Hu J, Hu J, et al. Aberrances of cortex excitability and connectivity underlying motor deficit in acute stroke. Neural Plast, 2018, 2018: 1318093.
13. Hensel L, Tscherpel C, Freytag J, et al. Connectivity-related roles of contralesional brain regions for motor performance early after stroke. Cereb Cortex, 2021, 31(2): 993-1007.
14. Volz LJ, Rehme AK, Michely J, et al. Shaping early reorganization of neural networks promotes motor function after stroke. Cereb Cortex, 2016, 26(6): 2882-2894.
15. Delorme M, Vergotte G, Perrey S, et al. Time course of sensorimotor cortex reorganization during upper extremity task accompanying motor recovery early after stroke: an fNIRS study. Restor Neurol Neurosci, 2019, 37(3): 207-218.
16. Sutcliffe L, Lumley H, Shaw L, et al. Surface electroencephalography (EEG) during the acute phase of stroke to assist with diagnosis and prediction of prognosis: a scoping review. BMC Emerg Med, 2022, 22(1): 29.
17. Delcamp C, Srinivasan R, Cramer SC. EEG provides insights into motor control and neuroplasticity during stroke recovery. Stroke, 2024, 55(10): 2579-2583.
18. Zhang Y, Chu H, Qiao Q, et al. Prospective analysis of quantitative EEG indices for predicting functional outcomes in acute ischemic stroke. SLAS Technol, 2025, 33: 100317.
19. Liu L, Zhang Z, Zhou Y, et al. Brain symmetry index predicts 3-month mortality in patients with acute large hemispheric infarction. Medicine (Baltimore), 2022, 101(47): e31620.
20. Min YS, Park JW, Park E, et al. Interhemispheric functional connectivity in the primary motor cortex assessed by resting-state functional magnetic resonance imaging aids long-term recovery prediction among subacute stroke patients with severe hand weakness. J Clin Med, 2020, 9(4): 975.
21. Xu G, Chen T, Yin J, et al. Lateralization of cortical activity, networks, and hemodynamic lag after stroke: a resting-state fNIRS study. J Biophotonics, 2024, 17(7): e202400012.
22. Pirovano I, Mastropietro A, Antonacci Y, et al. Resting state EEG directed functional connectivity unveils changes in motor network organization in subacute stroke patients after rehabilitation. Front Physiol, 2022, 13: 862207.
23. Hordacre B, Lotze M, Jenkinson M, et al. Fronto-parietal involvement in chronic stroke motor performance when corticospinal tract integrity is compromised. Neuroimage Clin, 2021, 29: 102558.
24. Diekhoff-Krebs S, Pool EM, Sarfeld AS, et al. Interindividual differences in motor network connectivity and behavioral response to iTBS in stroke patients. Neuroimage Clin, 2017, 15: 559-571.
25. Cai G, Xu J, Zhang C, et al. Identifying biomarkers related to motor function in chronic stroke: a fNIRS and TMS study. CNS Neurosci Ther, 2024, 30(7): e14889.
26. Lin Y, Jiang Z, Zhan G, et al. Brain network characteristics between subacute and chronic stroke survivors in active, imagery, passive movement task: a pilot study. Front Neurol, 2023, 14: 1143955.
27. Bai Z, Zhang JJ, Fong KNK. Intracortical and intercortical networks in patients after stroke: a concurrent TMS-EEG study. J Neuroeng Rehabil, 2023, 20(1): 100.
28. 劉蒙蒙, 徐桂芝, 于洪麗, 等. 經顱直流電刺激下腦卒中患者腦電功率譜密度研究. 生物醫學工程學雜志, 2022, 39(3): 498-506.
29. Bernardes TS, Santos KCS, Nascimento MR, et al. Effects of anodal transcranial direct current stimulation over motor cortex on resting-state brain activity in the early subacute stroke phase: a power spectral density analysis. Clin Neurol Neurosurg, 2024, 237: 108134.
30. Liu M, Xu G, Yu H, et al. Effects of transcranial direct current stimulation on EEG power and brain functional network in stroke patients. IEEE Trans Neural Syst Rehabil Eng, 2023, 31: 335-345.
31. Koch G, Bonnì S, Casula EP, et al. Effect of cerebellar stimulation on gait and balance recovery in patients with hemiparetic stroke: a randomized clinical trial. JAMA Neurol, 2019, 76(2): 170-178.
32. Bai Z, Zhang JJ, Fong KNK. Immediate effects of intermittent theta burst stimulation on primary motor cortex in stroke patients: a concurrent TMS-EEG study. IEEE Trans Neural Syst Rehabil Eng, 2023, 31: 2758-2766.
33. Fuggetta G, Pavone EF, Fiaschi A, et al. Acute modulation of cortical oscillatory activities during short trains of high-frequency repetitive transcranial magnetic stimulation of the human motor cortex: a combined EEG and TMS study. Hum Brain Mapp, 2008, 29(1): 1-13.
34. Qiu S, Wang S, Yi W, et al. The lasting effects of 1Hz repetitive transcranial magnetic stimulation on resting state EEG in healthy subjects. Annu Int Conf IEEE Eng Med Biol Soc, 2019, 2019: 5918-5922.
35. Groth CL, Singh A, Zhang Q, et al. GABAergic modulation in movement related oscillatory activity: a review of the effect pharmacologically and with aging. Tremor Other Hyperkinet Mov (N Y), 2021, 11: 48.
36. Premoli I, Bergmann TO, Fecchio M, et al. The impact of GABAergic drugs on TMS-induced brain oscillations in human motor cortex. Neuroimage, 2017, 163: 1-12.
37. Wilson TW, McDermott TJ, Mills MS, et al. tDCS modulates visual gamma oscillations and basal alpha activity in occipital cortices: evidence from MEG. Cereb Cortex, 2018, 28(5): 1597-1609.
38. Nicolo P, Magnin C, Pedrazzini E, et al. Comparison of neuroplastic responses to cathodal transcranial direct current stimulation and continuous theta burst stimulation in subacute stroke. Arch Phys Med Rehabil, 2018, 99(5): 862-872.e1.
39. Li C, Chen Y, Tu S, et al. Dual-tDCS combined with sensorimotor training promotes upper limb function in subacute stroke patients: a randomized, double-blinded, sham-controlled study. CNS Neurosci Ther, 2024, 30(4): e14530.
40. Grefkes C, Ward NS. Cortical reorganization after stroke: how much and how functional?. Neuroscientist, 2014, 20(1): 56-70.
41. Allman C, Amadi U, Winkler AM, et al. Ipsilesional anodal tDCS enhances the functional benefits of rehabilitation in patients after stroke. Sci Transl Med, 2016, 8(330): 330re1.
42. Yuan K, Ti CE, Wang X, et al. Individual electric field predicts functional connectivity changes after anodal transcranial direct-current stimulation in chronic stroke. Neurosci Res, 2023, 186: 21-32.
43. Lefebvre S, Dricot L, Laloux P, et al. Increased functional connectivity one week after motor learning and tDCS in stroke patients. Neuroscience, 2017, 340: 424-435.
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