Neural Regulation Technology Combined with Functional Neuroimaging in Stroke Rehabilitation: Mechanism Research and Application Progress

Stroke remains one of the leading causes of long-term disability worldwide, necessitating effective rehabilitation strategies to improve functional recovery. Recent advances in neural regulation technologies and functional neuroimaging have revolutionized our understanding of neural plasticity and recovery mechanisms following stroke. This review comprehensively examines the integration of neural regulation techniques—including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), and neurofeedback—with functional neuroimaging methods such as functional magnetic resonance imaging (fMRI), electroencephalography (EEG), near-infrared spectroscopy (NIRS), and magnetoencephalography (MEG) in stroke rehabilitation. We analyze the neurobiological mechanisms underlying these combinatorial approaches, including modulation of cortical excitability, enhancement of interhemispheric balance, promotion of brain connectivity reorganization, and facilitation of activity-dependent plasticity. Furthermore, this review evaluates clinical applications across motor, language, cognitive, and sensory domains of stroke rehabilitation, highlighting personalized neural regulation protocols based on neuroimaging biomarkers. Emerging technological innovations, methodological considerations, and future research directions are also discussed. The synergistic integration of neural regulation and neuroimaging holds promise for advancing precision medicine approaches in stroke rehabilitation through mechanism-based, individualized interventions that optimize functional recovery outcomes.