In the 15 years that Dr. Sean Dukelow has been treating stroke patients at Foothills Hospital in Calgary, Canada, he has had just one proven tool to offer them: neurorehabilitation. Performing the same actions over and over in speech therapy, physical therapy and occupational therapy has been shown to harness the brain’s natural plasticity, leading to neuron growth and new connections. “There’s going to be a lot of repetition,” he warns his patients.
Beyond that, therapies to boost long-term recovery are scant and limited to invasive implants that stimulate the vagus nerve or spinal cord. Now, neurologists are racing to find the first substance or device that could grease the wheels of healing — a turbo boost for brain recovery. “That turbo boost may be the difference between you walking again, talking again, being able to get home, versus having to go to a nursing home,” Dr. Dukelow said.
Promising contenders include transcranial magnetic stimulation, antidepressant pills and psychedelics, therapies that are better known for treating conditions like depression, post-traumatic stress disorder and obsessive-compulsive disorder. In psychiatry, these methods are thought to hack into the circuits that underlie memory and learning — the same circuits posited to animate stroke recovery.
The hope is that, in addition to changing old thought patterns, such therapies can help the brain find different ways to do the things it used to do — letting us walk, speak, remember — by forging new paths around dead and damaged neurons. But can therapies used to reset a disordered brain also help to repair a damaged one? Here’s what scientists know.
Transcranial Magnetic Stimulation
Unlike its much maligned ancestor, electroconvulsive therapy, T.M.S. is generally painless and memory-sparing; no seizure required. Coils wrap around the outside of the scalp, sending brief magnetic pulses with about the same power as an M.R.I. machine. It’s a “clever trick” to pass through the skull to stimulate brain circuits, said Dr. Mark George, a neurologist at the Medical University of South Carolina who pioneered the use of T.M.S. for depression.
Yet while T.M.S. has been shown to work for obsessive-compulsive disorder, migraines and smoking cessation, its use for stroke recovery remains contested. In general, clinical trials have been small and have shown mixed results. In April 2025, Dr. Dukelow published the results of a small trial in which he showed that T.M.S., paired with intensive speech therapy, could help stroke survivors speak more fluently more than six months after a stroke. One participant even relearned how to speak two of the four languages she had lost.