Neurotechnologies as tools for cognitive rehabilitation in stroke patients

ABSTRACT

Introduction

Cognitive impairments are one of the most common remaining symptoms after a stroke. The use of neurotechnologies to enhance cognitive performance is a rapidly emerging field with encouraging results.

Areas covered

Here, the authors empirically review the respective literature and critically discuss the technologies that are currently most often used for cognitive enhancement in stroke patients, which are computerized cognitive training, virtual reality, noninvasive brain stimulation and brain–computer interfaces. The authors describe their advantages/disadvantages and the challenges and limitations to overcome.

Expert opinion

Although the current results are promising, more research is needed to be able to make conclusive statements and translate these approaches successfully in daily clinical life. Multidiscipline collaborations could aid to improve current neurotechnologies and provide guidelines for future implementations.

KEYWORDS:

• Stroke
• cognition
• rehabilitation
• brain stimulation
• VR
• BCI
• CCT
• tDCS
• rTMS
• neurotechnology

Article highlights

• The use of neurotechnologies for cognitive rehabilitation is an upcoming and promising field for stroke rehabilitation.

• Computerized cognitive training is the most commonly used technique to enhance specific cognitive domains, but the translation to everyday life activities is still difficult.

• Immersive virtual reality is more effective and motivating than non-immersive and the practice of real-life situations is possible in a safe virtual environment.

• Non-invasive brain stimulation shows promising results for cognitive rehabilitation, but more research is needed to make conclusive statements.

• The use of neurofeedback with brain–computer interfaces shows potential, but developments to increase practicality and clinical translation is necessary.

• All these neurotechnologies have different underlying mechanisms of action, which result in varying advantages, but also challenges that still need to be overcome.

• More conclusive research is needed to work towards personalized medicine with possibly a combination of the neurotechnologies during different phases of rehabilitation.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The research was partially funded by the Wyss Foundation (ecoss WCP024; Genève, Switzerland), the Defitech Foundation (Morges, CH), the Bertarelli Foundation - Catalyst program (Gstaad, CH) and the Novartis foundation – Freenovation (Basel, CH).