Models to Tailor Brain Stimulation Therapies in Stroke

Figure 3

Presenting a schematic of unimodal models of recovery. Typically, unimodal models show how recovery following a motor therapy varies as a function of patient’s individual characteristics, like damage to ipsilesional pathways, or impairment of the paretic limb. When characteristics are plotted against patient’s response to motor therapy, one can understand who achieves criterion level of recovery (marked by X). Patients who achieve at least the criterion level or greater recovery are known as “responders.” Others are considered to have hit the “point of no return” (see Stinear et al. [81]). Degree of damage or deficit (or any other patient characteristic) that separates responders from nonresponders is deemed as cut-off to stratify patients for said therapy. It is important to note that criterion level of recovery, hence the cut-off, can vary from one therapy to another therapy and from study of one characteristic to another. If extrapolated, such recovery models can be effective at predicting who would respond to stimulation of ipsilesional M1.