Daily Repetitive Transcranial Magnetic Stimulation for Poststroke Upper Limb Paresis in the Subacute Period

Hosomi, Koichi; Morris, Shayne; Sakamoto, Tomosaburo; Taguchi, Junji; Maruo, Takeshi; Kageyama, Yu; Kinoshita, Yusuke; Goto, Yuko; Shimokawa, Toshio; Koyama, Tetsuo; Saitoh, Youichi

doi:10.1016/j.jstrokecerebrovasdis.2016.02.024

Cited by 64 publications

(70 citation statements)

References 29 publications

(57 reference statements)

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“…There was significant improvement in the hand function of both groups immediately after the combined therapy and at 2 weeks after combined therapy. This result was consistent with that of a previous study in which the grip strength of the affected hands was improved from the baseline only in the conventional therapy with real rTMS group compared to the conventional therapy with the sham rTMS group [ 23 ]. Our results could reinforce the evidence that low-frequency rTMS with hand training during the aftereffect period has positive effects on hand function.…”

Section: Discussionsupporting

confidence: 93%

Effects of Hand Training During the Aftereffect Period of Low-Frequency rTMS in Subacute Stroke Patients

et al. 2018

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ObjectiveTo investigate the effects of hand training using low-frequency repetitive transcranial magnetic stimulation (rTMS) within the aftereffect period on hand function in patients with subacute stroke.MethodsThe subacute stroke patients with hand weaknesses were divided randomly into two groups. Patients in the intervention group underwent hand training within the aftereffect period, that is, immediately after receiving low-frequency rTMS treatment. Patients in the control group underwent hand training 2 hours after the low-frequency rTMS treatment. A manual function test (MFT) for ‘grasp and pinch’ and ‘hand activities’; a manual muscle test (MMT) for ‘grasp’, ‘release’, and ‘abductor pollicis brevis (APB)’; and the Modified Ashworth Scale for finger flexion were performed and measured before and immediately after combined therapy as well as 2 weeks after combined therapy.ResultsThirty-two patients with hand weakness were enrolled in this study. The intervention group patients showed more improvements in grasp MMT and MMT APB tested immediately after combined therapy. However, the changes in all measurements were not significantly different between the two groups 2 weeks after the combined therapy. In both groups, hand functions improved significantly immediately after combined therapy and 2 weeks after combined therapy.ConclusionHand training immediately after low-frequency rTMS showed more rapid improvement in the motor power of hands than hand training conducted 2 hours after low-frequency rTMS. Our results suggest that conducting hand training immediately after low-frequency rTMS could be an improved useful therapeutic option in subacute stroke patients.

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Section: Discussionsupporting

confidence: 93%

Effects of Hand Training During the Aftereffect Period of Low-Frequency rTMS in Subacute Stroke Patients

et al. 2018

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“…Although some studies have shown benefits of early rTMS at the activity and participation levels [45, 46], their outcome measures may be contaminated by compensatory movements, limiting conclusions about effects on true reorganization [44]. Also excluded from discussion are studies that use subjective appraisals, such as visible muscle twitch to determine stimulation intensity [47, 48], as this limits replication and could lead to inconsistent neural modulation and behavioral response.…”

Section: Human Rtms Trials In Early Strokementioning

confidence: 99%

Repetitive Transcranial Magnetic Stimulation for Upper Extremity Motor Recovery: Does It Help?

Schambra

2018

Curr Neurol Neurosci Rep

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Purpose of Review Repetitive transcranial magnetic stimulation (rTMS) noninvasively modulates brain excitability in humans and influences mediators of plasticity in animals. When applied in humans in the months to years after stroke, potentiation of motor recovery has been limited. Recently, investigators have shifted rTMS administration into the early weeks following stroke, when injury-induced plasticity could be maximally engaged. This article provides an overview of basic mechanisms of rTMS, consideration of its interaction with various forms of neuroplasticity, and a summary of the highest quality clinical evidence for rTMS given early after stroke. Recent Findings Studies of repetitive magnetic stimulation in vitro and in vivo have found modulation of excitatory and inhibitory neurotransmission and induction of cellular mechanisms supporting plasticity. A handful of clinical studies have shown sustained improvements in grip strength and UE motor impairment when rTMS is delivered in the first weeks after stroke. Summary Though in its infancy, recent research suggests a plasticity-enhancing influence and modest motor recovery potentiation when rTMS is delivered early after stroke.

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“…Many studies were designed to stimulate the inhibition of the contralateral nonaffected primary motor area 3-12 months after a stroke, that is, during the chronic stage [5]. Daily high-frequency rTMS of the ipsilesional M1 is tolerable, and modestly facilitated motor recovery in the paralytic hand of subacute stroke patients [4]. Many studies in Japan found improved motor function of the upper limbs in chronic stroke patients [12,16].…”

Section: Tdcs Study In Post-stroke and Parkinson's Diseasementioning

confidence: 99%

“…Improvement of patients postinfarction occurs spontaneously within the first 3 months. Many studies on light to moderate paralysis using rTMS, there are no significant improvement that measure tool used in a study [4]. Improvement of patients postinfarction occurs spontaneously within the first 3 months and, in studies of light to moderate paralysis, the effectiveness of rTMS as evaluated by STEF and other such tools was not clear.…”

Section: Tdcs Study In Post-stroke and Parkinson's Diseasementioning

confidence: 99%

See 1 more Smart Citation

Non-Invasive Brain Stimulation (TMS/tDCS) and Rehabilitation for Stroke and Parkinson’s

Matsuda¹,

Manji²,

Amimoto³

et al. 2017

Neurological Physical Therapy

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The aim of this study was to clarify and compare the efficacies of rehabilitation using transcranial direct current stimulation (tDCS) and continuous theta burst stimulation (cTBS), a form of repetitive transcranial magnetic stimulation (rTMS), in convalescing stroke and Parkinson's disease patients. For both types of stimuli, kinetic analysis and performance analysis of upper limb motor paralysis and gait analysis showed an increase in speed of movement, and an improvement in performance was observed. Both stimuli resulted in significant improvement compared with a sham stimulus. Change in speed of movement and performance was observed with both tDCS and cTBS, but there was not a significantly large difference between the stimuli. Improved movement due to reduction of excessive tension caused by spasticity was observed. In patients with Parkinson's disease, gait speed and step length were increased. It is suggested that performance was improved because movement became smoother. The efficacy of tDCS and cTBS in patients with motor disorders caused by stroke or Parkinson's disease will probably be further improved when combined with physical therapy.

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Daily Repetitive Transcranial Magnetic Stimulation for Poststroke Upper Limb Paresis in the Subacute Period

Abstract: Our results suggest that dailyhigh-frequency rTMS of the ipsilesional M1 is tolerable and modestly facilitates motor recovery in the paralytic hand of subacute stroke patients.

Cited by 64 publications

References 29 publications

Effects of Hand Training During the Aftereffect Period of Low-Frequency rTMS in Subacute Stroke Patients

Effects of Hand Training During the Aftereffect Period of Low-Frequency rTMS in Subacute Stroke Patients

Repetitive Transcranial Magnetic Stimulation for Upper Extremity Motor Recovery: Does It Help?

Non-Invasive Brain Stimulation (TMS/tDCS) and Rehabilitation for Stroke and Parkinson’s

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