Use of Anodal Transcranial Direct Current Stimulation: Features, Facets, and Applications to Incomplete Spinal Cord Injury

Motor and sensory function impairments after an incomplete spinal cord injury generate a significant reduction in the functionality and quality of life, especially in a portion of working-age individuals. The development of research about effective interventions and adequate management should be a priority to rehabilitation postinjury. Anodal Transcranial Direct Current Stimulation, a low-intensity direct current, has been considered a noninvasive, painless, and safe stimulation. The anodal transcranial direct current stimulation effects appear to be related to modulation of the depolarization threshold in the neuronal membrane. Neuroplasticity in the neuronal circuit has been reported also. The potential to promote neuroplasticity by modulating the cortical excitability and motor descending pathways such as the corticospinal tract has an important place in rehabilitation. Therefore, stimuli to neuroplasticity to improve the effectiveness of rehabilitation after incomplete spinal cord injury should be investigated. Currently, anodal transcranial direct current stimulation effects on the cortical excitability, neuroplasticity, motor function, or functionality, and chronic neuropathic pain appear to reduce impairments after incomplete spinal cord injury. Studies should observe the short-, medium-, and long-term effects potentially related to the anodal transcranial direct current stimulation to define the therapy value to clinical practice. Besides, the cost-effectiveness and adherence level should be considered in future research.