
Fundamental principle of neuromodulation diagnosis and treatment technology based on the theory of central pathways and posture control and its clinical application
HE Lin, CHEN Yi, TAN Huixin, JIANG Hanhong, HE Kang, WEI Yixin, WEI Qingchuan, SONG Huiyan, GAO Qiang
Journal of Neurology and Neurorehabilitation ›› 2025, Vol. 21 ›› Issue (3) : 167-176.
Fundamental principle of neuromodulation diagnosis and treatment technology based on the theory of central pathways and posture control and its clinical application
Neurological disorders such as stroke and Parkinson's disease often lead to postural control and balance dysfunction. Traditional neuromodulation techniques primarily target the cerebral cortex, while research on modulation techniques and mechanisms involving the cerebellum and other neural circuits for postural control remains insufficient. Neuromodulation based on the theory of central pathways and posture control (CPPC) integrates sensory inputs including visual, vestibular and proprioceptive with multi-level neural pathways (e.g. medial and lateral motor systems), in combined with neuroplasticity mechanisms, to provide precise interventions for motor dysfunction. CPPC approach employs multimodal approaches, including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and repetitive peripheral magnetic stimulation (rPMS). It adheres to 4 principles, which are internal and external synergy, proximal-distal integration, multi-dimensional reconstruction and compliance with physiological principles. By targeting the cerebellum, core muscle groups and cortico-spinal pathways, CPPC-based neuromodulation techniques have demonstrated significant improvements in patients' balance and motor function. Clinical studies have shown that CPPC approach enhances neural remodeling and functional recovery through centralperipheral synergistic intervention and temporal coordination strategies. Future research should explore individualized target localization, dose-response relationships and mechanism of multimodal integration to improve the establishment of precision rehabilitation systems. CPPC approach provides new ideas for neurological rehabilitation and has significant implications on both clinical treatment and research.
Neurorehabilitation / Neuromodulation / Balance / Posture control / Central pathways and postural control
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