By their very nature, neuromodulation technologies, when used in the clinical context or in basic research, are tools of discovery. Basic and translational research in brain stimulation is advancing on many fronts. Much of this work uses stimulation techniques as probes to uncover the physiological basis and circuitry underlying changes in plasticity, gene expression, neurochemical release, and sensorimotor and higher cognitive and affective functions. neuromodulation technologies have been especially valuable in ‘brain mapping,’ identifying nodes in distributed networks whose modulation enhances or interferes with mental experience and behavior. Indeed, by mimicking functional lesions, these technologies allow for experimental testing of the role of specific brain regions in subserving distinct aspects of mental life. Similarly, these same techniques have been used productively to explore the neurocircuitry in elemental aspects of behavior (e.g., eye movements) or in regulation of neurochemical release.
It is fair to say, however, that the field of neuromodulation is in its infancy. Indeed, clinical applications have been tested largely without rational development. For example, we know much more about optimal forms of stimulation for cardiac muscle than we do for brain tissue. The absence of rational development reflects an inadequate basic science knowledge base, with large holes in our understanding of the biophysics of different forms of stimulation, limited capacity to quantify current density paths, and absence of parametric studies of the effects of stimulation on a host of biological and behavioral parameters. Thus, neuromodulation is a field of unusual promise, offering new tools for brain discovery and a new class of therapeutics. Yet, it is also a field whose clinical applications are spread across neurology, neurosurgery, psychiatry and rehabilitation, and whose basic research approaches have yet to integrate into an identified specialty, like pharmacology. The National Center of NM4R will serve as a focal point for integrating and developing this new science, with a specific focus on how to use this knowledge to enhance rehabilitation. It will crucially support investigators in use of these tools as research methods or potential treatments. The center will facilitate ‘rational development’ and use of neuromodulation methods in rehabilitation.
The National Center of Neuromodulation for Rehabilitation (NC NM4R) is supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under award number P2CHD086844. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.