A translational roadmap for transcranial magnetic and direct current stimulation in stroke rehabilitation: Consensus-based core recommendations from the third stroke recovery and rehabilitation roundtable.
Jodi D Edwards, Adan Ulises Dominguez-Vargas, Charlotte Rosso and 15 others
PMID 37837350WHAT IT FOUND
Experts identified five barriers preventing brain stimulation from becoming routine in stroke care.
They recommend stricter reporting, better animal models, and larger trials to prove which patients benefit before clinicians change practice.
Key findings
01Most clinical trials of brain stimulation were too small to determine which patients benefit, with over 70% having fewer than 50 participants.
02There is a lack of standardized reporting, with many trials failing to pre-register or report how blinding and sham stimulation were managed.
03Animal studies often use stimulation methods that do not match human practice, limiting their usefulness for predicting clinical outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a consensus statement and review, not a clinical trial. It does not report patient outcomes or prove the efficacy of any treatment. The recommendations are based on a review of literature from the last 10 years, which may miss very recent developments. The panel consisted of 18 experts, which may introduce selection bias despite efforts to include diverse career stages and locations.
Declared interests
The authors declared no potential conflicts of interest. Funding was provided by the Canadian Partnership for Stroke Recovery, the NHMRC Centre of Research Excellence, and unrestricted educational grants from Ipsen Pharma and Molex.
The easy way to misread this
Do not interpret these recommendations as evidence that brain stimulation works for stroke recovery. The paper states that current evidence is insufficient to change practice due to methodological flaws and small trial sizes. The focus is on fixing the research process, not on clinical efficacy.