Transcranial electrical stimulation for procedural learning and rehabilitation

Procedural learning is the acquisition of motor and non-motor skills through a gradual process that increases with practice. Impairments in procedural learning have been consistently demonstrated in neurodevelopmental, neurodegenerative, and neuropsychiatric disorders. Considering that noninvasive brain stimulation modulates brain activity and boosts neuroplastic mechanisms, we reviewed the effects of coupling transcranial direct current stimulation (tDCS) with training methods for motor and non-motor procedural learning to explore tDCS potential use as a tool for enhancing implicit learning in healthy and clinical populations. The review covers tDCS effects over i. motor procedural learning, from basic to complex activities; ii. non-motor procedural learning; iii. procedural rehabilitation in several clinical populations. We conclude that targeting the primary motor cortex and prefrontal areas seems the most promising for motor and non-motor procedural learning, respectively. For procedural rehabilitation, the use of tDCS is yet at an early stage but some effectiveness has been reported for implicit motor and memory learning. Still, systematic comparisons of stimulation parameters and target areas are recommended for maximising the effectiveness of tDCS and its robustness for procedural rehabilitation.
Olivia M. Lapenta is supported by the Center for Research in Psychology, School of Psychology, University of Minho and by the Portu guese Foundation for Science and Technology [FCT; UID/PSI/01662/2020] [SFRH/BPD/72710/2010]. Gabriel G. Rego is supported by a postdoctoral fellowship from the CNPq [166855/2023-5]. Paulo S. Boggio is supported by a CNPq researcher fellowship [309905/2019-2], CAPES - PRINT (Programa Institucional de Internacionalização [88887.310255/2018 – 00] and CNPq - INCT (Instituto Nacional de Ciência e Tecnologia [406463/2022-0].