, 2005; Khedr et al., 2005;
Kim et al., 2006; Talelli et al., 2007; Sparing et al., 2009). Moreover, anatomical and functional evidence supports the notion that perilesional tissue is a key component for reorganization and plasticity, leading to behavioral improvements after focal brain damage (Nudo, 1999, 2006; Mittmann STA-9090 concentration & Eysel, 2001; Werhahn et al., 2003). Accordingly, we tested the hypothesis that a direct manipulation of perilesional tissue activity in multiple sessions would maximize the magnitude and duration of the pursued therapeutic outcomes. Indeed, our findings confirm that in spite of inter-individual variability, high-frequency perilesional rTMS stimulation is capable of recovering real-space visuospatial function in chronically brain-damaged individuals. Nonetheless, the discussion on which factors might best account for such variability remains open. Results reveal that the level of spontaneous recovery seems to be the only significant predictor of positive rTMS improvements. More specifically,
low spontaneous recovery levels were associated with little benefit from rTMS rehabilitation in our group of Non-responders, while those with moderate spontaneous recovery prior to rTMS, within the group of Responders, benefited the most from stimulation. A closer inspection of eccentricity-specific recovery values shows click here that ameliorations progressed from pericentral to peripheral eccentricities.
Furthermore, Non-responders as opposed to Responders failed to fully recover spontaneously the ability to orient to targets presented at the most pericentral contralesional eccentricity, separated only 15o from fixation. This result suggests that a consistent and complete recovery of this specific spatial location might be essential to recover orienting in further peripheral eccentricities during the spontaneous recovery phase Farnesyltransferase and to show further improvements under neurostimulation. Regardless of where the processing and recovery of 15° took place, it appears that these early-recovered pericentral eccentricities served as a critical visual cue acting as a stepping-stone to facilitate awareness to progressively more eccentric locations within the neglected visual hemispace, increasing overall recovery. Without a doubt, one of the most intriguing aspects of the current study is the existence of contrasting behavioral effects in equally treated animals. Several studies have demonstrated that it is not uncommon to find large levels of inter-individual variability in electrophysiological and behavioral responses of healthy humans to rTMS (Maeda et al., 2000; Maeda & Pascual-Leone, 2003; Gangitano et al., 2002; Bäumer et al., 2003).