584727.fig.002a
(a)
584727.fig.002b
(b)
Figure 2: Mechanism and prevention of bimanual movement deterioration by NIBS in stroke patients. (a) Inhibitory NIBS over the unaffected hemisphere. Inhibitory NIBS decreases excitability of the contralesional motor cortex and increases excitability of the ipsilesional motor cortex by reducing interhemispheric inhibition from the unaffected to the affected hemisphere. Antiphase bimanual movement deteriorates due to the reduction in interhemispheric inhibition, which controls bimanual movement. (b) Bilateral NIBS. Excitatory NIBS, along with inhibitory NIBS, decreases excitability of the contralesional motor cortex and increases excitability of the ipsilesional motor cortex. However, bilateral NIBS limits the reduction in interhemispheric inhibition induced by inhibitory NIBS and prevents antiphase bimanual movement deterioration. Modified from Takeuchi et al. [42].