Therapeutic Neuromodulation of the Cerebellum for Upper-Extremity Stroke Recovery

Stroke remains a leading cause of permanent disability worldwide, with limited options available to improve long-term functional outcome. Traditionally recognized for its role in motor coordination, the cerebellum is highly interconnected with widespread thalamocortical circuits, making it a promising target for neuromodulation-based interventions that propose to influence motor circuits and enhance function. Here, we present an overview of current neurostimulation-based approaches being used to target cerebellar output, including more recent efforts using surgically based, deep brain stimulation techniques. Overall, the efforts to date across both noninvasive and invasive techniques suggest that the cerebellum with its widespread projections throughout the nervous system may be a promising neurostimulation target for promoting poststroke rehabilitation beyond current standard of care practice.