Neuromuscular Fatigue in Stroke Survivors: Understanding the Central-Peripheral Interaction and the Therapeutic Potential of tACS

Neuromuscular fatigue (NMF), an exercise-induced decline in muscle force, hinders rehabilitation and physical independence in stroke survivors. While brain-muscle interaction is essential for sustaining motor performance, how central (brain-related) and peripheral (muscle-related) components contribute to and interact in NMF post-stroke remains unclear. Employing electroencephalography (EEG) and electromyography (EMG) offers a powerful framework to investigate how disrupted neural oscillations, impaired motor unit recruitment, and altered muscle composition contribute to NMF, providing deeper insights into its manifestation. Transcranial alternating current stimulation (tACS) modulates cortical rhythms by entraining neural oscillations, a promising strategy that could delay or mitigate NMF in stroke survivors. Although tACS has shown potential in enhancing motor recovery and functional connectivity, its effects on NMF remain unexplored. In this project, I will (1) conduct the first meta-analysis to synthesize existing knowledge on central and peripheral changes related to NMF, (2) investigate and compare central (EEG) and peripheral (EMG) NMF components in stroke survivors versus healthy individuals, and (3) assess the effects of tACS on NMF. By addressing fundamental knowledge gaps, my research provides first-ever insights into post-stroke NMF mechanisms and explores neuromodulation’s potential to optimize rehabilitation and functional recovery in stroke survivors