Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Technology Insight: noninvasive brain stimulation in neurology—perspectives on the therapeutic potential of rTMS and tDCS

Abstract

In neurology, as in all branches of medicine, symptoms of disease and the resulting burden of illness and disability are not simply the consequence of the injury, inflammation or dysfunction of a given organ; they also reflect the consequences of the nervous system's attempt to adapt to the insult. This plastic response includes compensatory changes that prove adaptive for the individual, as well as changes that contribute to functional disability and are, therefore, maladaptive. In this context, brain stimulation techniques tailored to modulate individual plastic changes associated with neurological diseases might enhance clinical benefits and minimize adverse effects. In this Review, we discuss the use of two noninvasive brain stimulation techniques—repetitive transcranial magnetic stimulation and transcranial direct current stimulation—to modulate activity in the targeted cortex or in a dysfunctional network, to restore an adaptive equilibrium in a disrupted network for best behavioral outcome, and to suppress plastic changes for functional advantage. We review randomized controlled studies, in focal epilepsy, Parkinson's disease, recovery from stroke, and chronic pain, to illustrate these principles, and we present evidence for the clinical effects of these two techniques.

Key Points

  • The clinical consequences of brain insults include compensatory plastic changes that can be either adaptive or maladaptive

  • An ideal therapy should be tailored to the individual, promote compensatory plastic changes, inhibit maladaptive plastic changes, be associated with minimal or no adverse effects, be highly effective, and be financially and practically feasible

  • An advantage of brain stimulation is that it can be focal and targeted to the underlying pathophysiology of the patient

  • Two techniques of noninvasive brain stimulation—repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)—are powerful tools for brain modulation

  • A growing number of proof-of-principle and pilot studies have revealed that rTMS and tDCS are associated with mild adverse effects and can induce clinical benefits; however, the evidence for efficacy is currently insufficient

  • Initial studies have shown that noninvasive brain stimulation can be used to modulate activity in the targeted cortex (focal epilepsy); modulate activity in a dysfunctional corticosubcortical network (Parkinson's disease); restore adaptive equilibrium in a disrupted network (stroke); or suppress plastic changes for functional advantage (pain)

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Noninvasive brain stimulation in chronic pain
Figure 2: Noninvasive brain stimulation in stroke
Figure 3: Noninvasive brain stimulation in Parkinson's disease
Figure 4: Noninvasive brain stimulation in focal epilepsy

Similar content being viewed by others

References

  1. Coffey RJ (2001) Deep brain stimulation for chronic pain: results of two multicenter trials and a structured review. Pain Med 2: 183–192

    Article  CAS  PubMed  Google Scholar 

  2. Moro E and Lang AE (2006) Criteria for deep-brain stimulation in Parkinson's disease: review and analysis. Expert Rev Neurother 6: 1695–1705

    Article  PubMed  Google Scholar 

  3. Bindman LJ et al. (1964) The action of brief polarizing currents on the cerebral cortex of the rat (1) during current flow and (2) in the production of long-lasting after-effects. J Physiol 172: 369–382

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Purpura DP and McMurtry JG (1965) Intracellular activities and evoked potential changes during polarization of motor cortex. J Neurophysiol 28: 166–185

    Article  CAS  PubMed  Google Scholar 

  5. Nitsche MA et al. (2003) Modulation of cortical excitability by weak direct current stimulation—technical, safety and functional aspects. Suppl Clin Neurophysiol 56: 255–276

    Article  PubMed  Google Scholar 

  6. Priori A (2003) Brain polarization in humans: a reappraisal of an old tool for prolonged non-invasive modulation of brain excitability. Clin Neurophysiol 114: 589–595

    Article  PubMed  Google Scholar 

  7. Wagner T et al. (2007) Transcranial direct current stimulation: a computer-based human model study. Neuroimage 35: 1113–1124

    Article  PubMed  Google Scholar 

  8. Miranda PC et al. (2006) Modeling the current distribution during transcranial direct current stimulation. Clin Neurophysiol 117: 1623–1629

    Article  PubMed  Google Scholar 

  9. Nitsche MA and Paulus W (2001) Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans. Neurology 57: 1899–1901

    Article  CAS  PubMed  Google Scholar 

  10. Walsh V et al. (2005) Transcranial Magnetic Stimulation: A Neurochronometrics of Mind. Cambridge, MA: MIT Press

    Google Scholar 

  11. Barker AT et al. (1985) Non-invasive magnetic stimulation of human motor cortex. Lancet 1: 1106–1107

    Article  CAS  PubMed  Google Scholar 

  12. Hallett M (2000) Transcranial magnetic stimulation and the human brain. Nature 406: 147–150

    Article  CAS  PubMed  Google Scholar 

  13. Pascual-Leone A et al. (1999) Transcranial magnetic stimulation and neuroplasticity. Neuropsychologia 37: 207–217

    Article  CAS  PubMed  Google Scholar 

  14. Fregni F et al. (2007) Recent advances in the treatment of chronic pain with non-invasive brain stimulation techniques. Lancet Neurol 6: 188–191

    Article  PubMed  Google Scholar 

  15. Patrizi F et al. (2006) Novel therapeutic approaches to the treatment of chronic abdominal visceral pain. ScientificWorldJournal 6: 472–490

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Craig AD (2003) Pain mechanisms: labeled lines versus convergence in central processing. Annu Rev Neurosci 26: 1–30

    Article  CAS  PubMed  Google Scholar 

  17. Drossman DA (1996) Chronic functional abdominal pain. Am J Gastroenterol 91: 2270–2281

    CAS  PubMed  Google Scholar 

  18. Ringel Y and Drossman DA (1999) From gut to brain and back—a new perspective into functional gastrointestinal disorders. J Psychosom Res 47: 205–210

    Article  CAS  PubMed  Google Scholar 

  19. Mundinger F and Salomao JF (1980) Deep brain stimulation in mesencephalic lemniscus medialis for chronic pain. Acta Neurochir Suppl (Wien) 30: 245–258

    Article  CAS  Google Scholar 

  20. Ray CD and Burton CV (1980) Deep brain stimulation for severe, chronic pain. Acta Neurochir Suppl (Wien) 30: 289–293

    Article  CAS  Google Scholar 

  21. García-Larrea L et al. (1999) Electrical stimulation of motor cortex for pain control: a combined PET-scan and electrophysiological study. Pain 83: 259–273

    Article  PubMed  Google Scholar 

  22. Tsubokawa T et al. (1993) Chronic motor cortex stimulation in patients with thalamic pain. J Neurosurg 78: 393–401

    Article  CAS  PubMed  Google Scholar 

  23. Peyron R et al. (1995) Electrical stimulation of precentral cortical area in the treatment of central pain: electrophysiological and PET study. Pain 62: 275–286

    Article  CAS  PubMed  Google Scholar 

  24. García-Larrea L et al. (1997) Positron emission tomography during motor cortex stimulation for pain control. Stereotact Funct Neurosurg 68: 141–148

    Article  PubMed  Google Scholar 

  25. Lefaucheur JP et al. (2004) Neurogenic pain relief by repetitive transcranial magnetic cortical stimulation depends on the origin and the site of pain. J Neurol Neurosurg Psychiatry 75: 612–616

    Article  PubMed  PubMed Central  Google Scholar 

  26. Pleger B et al. (2004) Repetitive transcranial magnetic stimulation of the motor cortex attenuates pain perception in complex regional pain syndrome type I. Neurosci Lett 356: 87–90

    Article  CAS  PubMed  Google Scholar 

  27. Khedr EM et al. (2005) Longlasting antalgic effects of daily sessions of repetitive transcranial magnetic stimulation in central and peripheral neuropathic pain. J Neurol Neurosurg Psychiatry 76: 833–838

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. André-Obadia N et al. (2006) Transcranial magnetic stimulation for pain control: double-blind study of different frequencies against placebo, and correlation with motor cortex stimulation efficacy. Clin Neurophysiol 117: 1536–1544

    Article  PubMed  Google Scholar 

  29. Fregni F et al. (2006) A sham-controlled, phase II trial of transcranial direct current stimulation for the treatment of central pain in traumatic spinal cord injury. Pain 122: 197–209

    Article  PubMed  Google Scholar 

  30. Fregni F et al. (2006) A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. Arthritis Rheum 54: 3988–3998.

    Article  PubMed  Google Scholar 

  31. Graff-Guerrero A et al. (2005) Repetitive transcranial magnetic stimulation of dorsolateral prefrontal cortex increases tolerance to human experimental pain. Brain Res Cogn Brain Res 25: 153–160

    Article  PubMed  Google Scholar 

  32. Borckardt JJ et al. (2006) Postoperative left prefrontal repetitive transcranial magnetic stimulation reduces patient-controlled analgesia use. Anesthesiology 105: 557–562

    Article  CAS  PubMed  Google Scholar 

  33. Ward NS et al. (2003) Neural correlates of outcome after stroke: a cross-sectional fMRI study. Brain 126: 1430–1448

    Article  CAS  PubMed  Google Scholar 

  34. Ward NS et al. (2003) Neural correlates of motor recovery after stroke: a longitudinal fMRI study. Brain 126: 2476–2496

    Article  CAS  PubMed  Google Scholar 

  35. Galea MP and Darian-Smith I (1994) Multiple corticospinal neuron populations in the macaque monkey are specified by their unique cortical origins, spinal terminations, and connections. Cereb Cortex 4: 166–194

    Article  CAS  PubMed  Google Scholar 

  36. Brinkman J and Kuypers HG (1973) Cerebral control of contralateral and ipsilateral arm, hand and finger movements in the split-brain rhesus monkey. Brain 96: 653–674

    Article  CAS  PubMed  Google Scholar 

  37. Crafton KR et al. (2003) Improved understanding of cortical injury by incorporating measures of functional anatomy. Brain 126: 1650–1659

    Article  PubMed  Google Scholar 

  38. Zemke AC et al. (2003) Motor cortex organization after stroke is related to side of stroke and level of recovery. Stroke 34: e23–e28

    Article  PubMed  Google Scholar 

  39. Traversa R et al. (1997) Mapping of motor cortical reorganization after stroke: a brain stimulation study with focal magnetic pulses. Stroke 28: 110–117

    Article  CAS  PubMed  Google Scholar 

  40. Cicinelli P et al. (1997) Post-stroke reorganization of brain motor output to the hand: a 2–4 month follow-up with focal magnetic transcranial stimulation. Electroencephalogr Clin Neurophysiol 105: 438–450

    Article  CAS  PubMed  Google Scholar 

  41. Dijkhuizen RM et al. (2003) Correlation between brain reorganization, ischemic damage, and neurologic status after transient focal cerebral ischemia in rats: a functional magnetic resonance imaging study. J Neurosci 23: 510–517

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Marshall RS et al. (2000) Evolution of cortical activation during recovery from corticospinal tract infarction. Stroke 31: 656–661

    Article  CAS  PubMed  Google Scholar 

  43. Feydy A et al. (2002) Longitudinal study of motor recovery after stroke: recruitment and focusing of brain activation. Stroke 33: 1610–1617

    Article  CAS  PubMed  Google Scholar 

  44. Theoret H et al. (2003) Exploring paradoxical functional facilitation with TMS. Suppl Clin Neurophysiol 56: 211–219

    Article  PubMed  Google Scholar 

  45. Shimizu T et al. (2002) Motor cortical disinhibition in the unaffected hemisphere after unilateral cortical stroke. Brain 125: 1896–1907

    Article  PubMed  Google Scholar 

  46. Murase N et al. (2004) Influence of interhemispheric interactions on motor function in chronic stroke. Ann Neurol 55: 400–409

    Article  PubMed  Google Scholar 

  47. Kinsbourne M (1977) Hemi-neglect and hemisphere rivalry. Adv Neurol 18: 41–49

    CAS  PubMed  Google Scholar 

  48. Maeda F et al. (2002) Inter- and intra-individual variability of paired-pulse curves with transcranial magnetic stimulation (TMS). Clin Neurophysiol 113: 376–382

    Article  PubMed  Google Scholar 

  49. Kobayashi M et al. (2004) Repetitive TMS of the motor cortex improves ipsilateral sequential simple finger movements. Neurology 62: 91–98

    Article  CAS  PubMed  Google Scholar 

  50. Schambra HM et al. (2003) Modulation of excitability of human motor cortex (M1) by 1 Hz transcranial magnetic stimulation of the contralateral M1. Clin Neurophysiol 114: 130–133

    Article  CAS  PubMed  Google Scholar 

  51. Hilgetag CC et al. (2001) Enhanced visual spatial attention ipsilateral to rTMS-induced 'virtual lesions' of human parietal cortex. Nat Neurosci 4: 953–957

    Article  CAS  PubMed  Google Scholar 

  52. Fregni F and Pascual-Leone A (2006) Hand motor recovery after stroke: tuning the orchestra to improve hand motor function. Cogn Behav Neurol 19: 21–33

    Article  PubMed  Google Scholar 

  53. Hummel FC and Cohen LG (2006) Non-invasive brain stimulation: a new strategy to improve neurorehabilitation after stroke? Lancet Neurol 5: 708–712

    Article  PubMed  Google Scholar 

  54. Johansen-Berg H et al. (2002) The role of ipsilateral premotor cortex in hand movement after stroke. Proc Natl Acad Sci USA 99: 14518–14523

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Lotze M et al. (2006) The role of multiple contralesional motor areas for complex hand movements after internal capsular lesion. J Neurosci 26: 6096–6102

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Oliveri M et al. (1999) Left frontal transcranial magnetic stimulation reduces contralesional extinction in patients with unilateral right brain damage. Brain 122: 1731–1739

    Article  PubMed  Google Scholar 

  57. Martin PI et al. (2004) Transcranial magnetic stimulation as a complementary treatment for aphasia. Semin Speech Lang 25: 181–191

    Article  PubMed  Google Scholar 

  58. Naeser MA et al. (2005) Improved picture naming in chronic aphasia after TMS to part of right Broca's area: an open-protocol study. Brain Lang 93: 95–105

    Article  PubMed  Google Scholar 

  59. Fregni F et al. (2006) A sham-controlled trial of a 5-day course of repetitive transcranial magnetic stimulation of the unaffected hemisphere in stroke patients. Stroke 37: 2115–2122

    Article  PubMed  Google Scholar 

  60. Kim YH et al. (2006) Repetitive transcranial magnetic stimulation-induced corticomotor excitability and associated motor skill acquisition in chronic stroke. Stroke 37: 1471–1476

    Article  PubMed  Google Scholar 

  61. Hummel F et al. (2005) Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain 128: 490–499

    Article  PubMed  Google Scholar 

  62. Khedr EM et al. (2005) Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke. Neurology 65: 466–468

    Article  PubMed  Google Scholar 

  63. Hummel FC et al. (2006) Effects of brain polarization on reaction times and pinch force in chronic stroke. BMC Neurosci 7: 73

    Article  PubMed  PubMed Central  Google Scholar 

  64. Boggio PS et al. (2006) Hand function improvement with low-frequency repetitive transcranial magnetic stimulation of the unaffected hemisphere in a severe case of stroke. Am J Phys Med Rehabil 85: 927–930

    Article  PubMed  Google Scholar 

  65. Naeser MA et al. (2005) Improved naming after TMS treatments in a chronic, global aphasia patient—case report. Neurocase 11: 182–193

    Article  PubMed  PubMed Central  Google Scholar 

  66. Feeney DM et al. (1982) Amphetamine, haloperidol, and experience interact to affect rate of recovery after motor cortex injury. Science 217: 855–857

    Article  CAS  PubMed  Google Scholar 

  67. Gladstone DJ and Black SE (2000) Enhancing recovery after stroke with noradrenergic pharmacotherapy: a new frontier? Can J Neurol Sci 27: 97–105

    Article  CAS  PubMed  Google Scholar 

  68. Plautz EJ et al. (2003) Post-infarct cortical plasticity and behavioral recovery using concurrent cortical stimulation and rehabilitative training: a feasibility study in primates. Neurol Res 25: 801–810

    Article  PubMed  Google Scholar 

  69. Brown JA et al. (2006) Motor cortex stimulation for the enhancement of recovery from stroke: a prospective, multicenter safety study. Neurosurgery 58: 464–473

    Article  PubMed  Google Scholar 

  70. Sick TJ et al. (1999) Mild hypothermia improves recovery of cortical extracellular potassium ion activity and excitability after middle cerebral artery occlusion in the rat. Stroke 30: 2416–2421

    Article  CAS  PubMed  Google Scholar 

  71. Valero-Cabre A and Pascual-Leone A (2005) Impact of TMS on the primary motor cortex and associated spinal systems. IEEE Eng Med Biol Mag 24: 29–35

    Article  PubMed  Google Scholar 

  72. van Eimeren T and Siebner HR (2006) An update on functional neuroimaging of parkinsonism and dystonia. Curr Opin Neurol 19: 412–419

    Article  PubMed  Google Scholar 

  73. Lefaucheur JP (2006) Repetitive transcranial magnetic stimulation (rTMS): insights into the treatment of Parkinson's disease by cortical stimulation. Neurophysiol Clin 36: 125–133

    Article  CAS  PubMed  Google Scholar 

  74. Strafella AP et al. (2001) Repetitive transcranial magnetic stimulation of the human prefrontal cortex induces dopamine release in the caudate nucleus. J Neurosci 21: RC157

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Cunic D et al. (2002) Effects of subthalamic nucleus stimulation on motor cortex excitability in Parkinson's disease. Neurology 58: 1665–1672

    Article  CAS  PubMed  Google Scholar 

  76. Fregni F et al. (2005) Non-invasive brain stimulation for Parkinson's disease: a systematic review and meta-analysis of the literature. J Neurol Neurosurg Psychiatry 76: 1614–1623

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Okabe S et al. (2003) 0.2 Hz repetitive transcranial magnetic stimulation has no add-on effects as compared to a realistic sham stimulation in Parkinson's disease. Mov Disord 18: 382–388

    Article  PubMed  Google Scholar 

  78. Pascual-Leone A et al. (1994) Akinesia in Parkinson's disease. I: shortening of simple reaction time with focal, single-pulse transcranial magnetic stimulation. Neurology 44: 884–891

    Article  CAS  PubMed  Google Scholar 

  79. Ghabra MB et al. (1999) Simultaneous repetitive transcranial magnetic stimulation does not speed fine movement in PD. Neurology 52: 768–770

    Article  CAS  PubMed  Google Scholar 

  80. Fregni F et al. (2006) Effects of antidepressant treatment with rTMS and fluoxetine on brain perfusion in PD. Neurology 66: 1629–1637

    Article  CAS  PubMed  Google Scholar 

  81. Boggio PS et al. (2005) Effect of repetitive TMS and fluoxetine on cognitive function in patients with Parkinson's disease and concurrent depression. Mov Disord 20: 1178–1184

    Article  PubMed  Google Scholar 

  82. Boggio PS et al. (2006) Effects of transcranial direct current stimulation on working memory in patients with Parkinson's disease. J Neurol Sci 249: 31–38

    Article  PubMed  Google Scholar 

  83. Johnston MV (1996) Developmental aspects of epileptogenesis. Epilepsia 37 (Suppl 1): S2–S9

    Article  PubMed  Google Scholar 

  84. Lowenstein DH (1996) Recent advances related to basic mechanisms of epileptogenesis. Epilepsy Res Suppl 11: 45–60

    CAS  PubMed  Google Scholar 

  85. Chen R et al. (1997) Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation. Neurology 48: 1398–1403

    Article  CAS  PubMed  Google Scholar 

  86. Nitsche MA et al. (2005) Modulating parameters of excitability during and after transcranial direct current stimulation of the human motor cortex. J Physiol 568: 291–303

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Dhuna A et al. (1991) Transcranial magnetic stimulation in patients with epilepsy. Neurology 41: 1067–1071

    Article  CAS  PubMed  Google Scholar 

  88. Misawa S et al. (2005) Low-frequency transcranial magnetic stimulation for epilepsia partialis continua due to cortical dysplasia. J Neurol Sci 234: 37–39

    Article  PubMed  Google Scholar 

  89. Theodore WH et al. (2002) Transcranial magnetic stimulation for the treatment of seizures: a controlled study. Neurology 59: 560–562

    Article  CAS  PubMed  Google Scholar 

  90. Fregni F et al. (2006) A randomized clinical trial of repetitive transcranial magnetic stimulation in patients with refractory epilepsy. Ann Neurol 60: 447–455

    Article  PubMed  Google Scholar 

  91. Pascual-Leone A et al. (2002) Handbook of Transcranial Magnetic Stimulation. London: Arnold Press

    Google Scholar 

  92. Joo EY et al. (2007) Antiepileptic effects of low-frequency repetitive transcranial magnetic stimulation by different stimulation durations and locations. Clin Neurophysiol 118: 702–708

    Article  PubMed  Google Scholar 

  93. Kanno M et al. (2001) Monitoring an electroencephalogram for the safe application of therapeutic repetitive transcranial magnetic stimulation. J Neurol Neurosurg Psychiatry 71: 559–560

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Menkes DL and Gruenthal M (2000) Slow-frequency repetitive transcranial magnetic stimulation in a patient with focal cortical dysplasia. Epilepsia 41: 240–242

    Article  CAS  PubMed  Google Scholar 

  95. Fregni F et al. (2005) Antiepileptic effects of repetitive transcranial magnetic stimulation in patients with cortical malformations: an EEG and clinical study. Stereotact Funct Neurosurg 83: 57–62

    Article  PubMed  Google Scholar 

  96. Gandiga PC et al. (2006) Transcranial DC stimulation (tDCS): a tool for double-blind sham-controlled clinical studies in brain stimulation. Clin Neurophysiol 117: 845–850

    Article  PubMed  Google Scholar 

  97. Strafella AP et al. (2006) Therapeutic application of transcranial magnetic stimulation in Parkinson's disease: the contribution of expectation. Neuroimage 31: 1666–1672

    Article  PubMed  Google Scholar 

  98. Fregni F et al. (2006) Immediate placebo effect in Parkinson's disease—is the subjective relief accompanied by objective improvement? Eur Neurol 56: 222–229

    Article  PubMed  Google Scholar 

  99. Rossi S et al. (2007) A real electro-magnetic placebo (REMP) device for sham transcranial magnetic stimulation (TMS). Clin Neurophysiol 118: 709–716

    Article  PubMed  Google Scholar 

  100. Fitzgerald PB et al. (2006) A randomized, controlled trial of sequential bilateral repetitive transcranial magnetic stimulation for treatment-resistant depression. Am J Psychiatry 163: 88–94

    Article  PubMed  Google Scholar 

  101. Iyer MB et al. (2003) Priming stimulation enhances the depressant effect of low-frequency repetitive transcranial magnetic stimulation. J Neurosci 23: 10867–10872

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  102. Huang YZ et al. (2005) Theta burst stimulation of the human motor cortex. Neuron 45: 201–206

    Article  CAS  PubMed  Google Scholar 

  103. Roth Y et al. (2007) Three-dimensional distribution of the electric field induced in the brain by transcranial magnetic stimulation using figure-8 and deep H-coils. J Clin Neurophysiol 24: 31–38

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work was partially supported by grants from the NIH (K24 RR018875, RO1-DC05672, RO1-NS 47754, RO1-NS 20068, R01-EB 005047, RO1-NS47754, RO3-DK071851).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alvaro Pascual-Leone.

Ethics declarations

Competing interests

A Pascual-Leone holds the patent for the TMS–EEG combination (US Patent 6571123), and has received research grants from Northstar Neuroscience for cortical stimulation work. F Fregni declared he has no competing interests.

Supplementary information

Supplementary Table 1

Noninvasive brain stimulation and chronic pain (DOC 63 kb)

Supplementary Table 2

Noninvasive brain stimulation and stroke (DOC 48 kb)

Supplementary Table 3

Noninvasive brain stimulation and Parkinson's disease (DOC 62 kb)

Supplementary Table 4

Noninvasive brain stimulation and epilepsy (DOC 31 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fregni, F., Pascual-Leone, A. Technology Insight: noninvasive brain stimulation in neurology—perspectives on the therapeutic potential of rTMS and tDCS. Nat Rev Neurol 3, 383–393 (2007). https://doi.org/10.1038/ncpneuro0530

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpneuro0530

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing