Modulating Neuronal Networks to Enhance Postural Control: A Review of Transcranial Direct Current Stimulation Approach

Context: Postural stability is essential for performing everyday activities. The central nervous system (CNS) must modify balance control to provide stability to intrinsic and external perturbations. Methods considered as the main candidates for ultimate promotion of neural plasticity could be used for rehabilitation to enhance motor performance. The Transcranial Direct Current Stimulation (tDCS) as a non-invasive brain stimulation tool is applied over the cortex to accentuate and/or accelerate neural effects on network connectivity. Objectives: This study aimed to address the impact of tDCS intervention on balance recovery. We postulated that tDCS induces neuroplasticity that is fundamental for refining motor behaviors such as postural stability during rehabilitation. Methods: The present review discusses the tDCS application over the important areas of the CNS that are responsible for the sensorimotor processing of balance-relevant information. We searched ProQuest, PubMed, Science Direct, Cochrane, and Google Scholar for randomized, controlled trials that assessed the efficacy of tDCS intervention in improving balance impairment following neurologic disorders and enhancing postural stability in a healthy population. Results: Recent studies provide insights into the effects of tDCS on postural stability. Based on the defined criteria, there is a positive response to tDCS, but the underlying neural mechanisms are yet unknown. We suggest that interventions promoting more neural plasticity are crucial for better balance training outcomes and improved effectiveness of rehabilitation programs. Conclusions: Balance recovery after tDCS needs to be more investigated. The tDCS might be considered as an adjunct preventive strategy to provide functional recovery and reduce the adverse effects of balance impairment.