Noninvasive transcranial brain stimulation to treat visuospatial neglect

In this chapter, we explore the potential of noninvasive brain stimulation (NIBS) as a therapeutic intervention for treating visuospatial neglect, a common consequence of stroke. Hemispatial neglect significantly impairs patients' ability to perceive and respond to stimuli on one side of space, affecting rehabilitation outcomes. Traditional treatments have shown limited success, prompting the investigation into NIBS techniques such as transcranial electrical stimulation (tES) and transcranial magnetic stimulation (TMS). We discuss various tES protocols, including transcranial direct current stimulation (tDCS) transcranial alternating current stimulation (tACS), and repetitive TMS (rTMS) and its synergistic effects when combined with other interventions. NIBS, particularly TMS targeting the contralesional posterior parietal cortex (PPC), shows strong efficacy in reducing neglect severity, with effects lasting for months posttreatment. While there is moderate evidence supporting the efficacy of tES, further research with larger samples and longer follow-ups is needed to maximize benefits across all stroke phases. Ultimately, establishing a higher level of evidence for NIBS techniques is essential to normalize their use in neurorehabilitation settings.