Long-term effect of repetitive transcranial magnetic stimulation on disability in patients with stroke

Nam, Kyung Eun; Jo, Leechan; Jun, So Yeon; Sung, Won; Kim, Joon Sung; Hong, Bo Young; Sul, Bomi; Lim, Seong Hoon

doi:10.1016/j.jocn.2017.10.010

Cited by 9 publications

(7 citation statements)

References 19 publications

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“…In contrast to our results, several studies have reported the positive short-and long-term effectiveness of rTMS treatment on recovery of motor function after stroke (Chang et al, 2010;He et al, 2019;Nam et al, 2018;Noh et al, 2019;Ueda et al, 2019). Previous studies proposed that increased excitability of the affected hemisphere by rTMS treatment improves motor function by facilitating corticomotor excitability (Khedr et al, 2010;Kim et al, 2006;Wassermann, 1998).…”

Section: Discussioncontrasting

confidence: 99%

Can repetitive transcranial magnetic stimulation enhance motor outcomes in cerebral infarct patients?

Kim

Boudier‐Revéret

Lee

2020

J. Integr. Neurosci.

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The effectiveness of repetitive transcranial magnetic stimulation on the post-stroke motor recovery is not apparent. To perform an accurate evaluation, we adjusted for critical factors that determine motor outcomes, including lesion location and the state of the corticospinal tract. We only included patients with cerebral infarct in the corona radiata and with corticospinal tract interruption, apparent on diffusion tensor tractography. We retrospectively enrolled 34 patients whose diffusion tensor tractography corticospinal tract was interrupted by a cerebral infarct. The corticospinal tract state of each patient was evaluated using diffusion tensor tractography. Of the 34 patients whose corticospinal tract was interrupted on diffusion tensor tractography, 12 patients underwent repetitive transcranial magnetic stimulation treatment at the early stage after cerebral infarct (repetitive transcranial magnetic stimulation group). In comparison, 22 patients did not receive repetitive transcranial magnetic stimulation treatment (non-repetitive transcranial magnetic stimulation group). High-frequency repetitive transcranial magnetic stimulation (10 Hz) was performed on the primary motor cortex of the affected hemisphere. At the six month evaluation after the onset of the infarct, motor function was measured in each patient. In both groups, compared to their states during the initial evaluation, significant improvement was found in all measurements of motor function. However, six months after onset, no significant differences between the two groups were found in these measurement scores. When a patient’s CST is interrupted, high-frequency repetitive transcranial magnetic stimulation treatment at the early stage after cerebral infarct might have no additional therapeutic effect on motor outcome. Qualified randomized controlled trials are needed to support our findings further.

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Section: Discussioncontrasting

confidence: 99%

Can repetitive transcranial magnetic stimulation enhance motor outcomes in cerebral infarct patients?

Kim

Boudier‐Revéret

Lee

2020

J. Integr. Neurosci.

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“…The remaining 16 studies were assessed for eligibility. A total of 3 studies were excluded because a frequency other than 10 Hz rTMS was used [17][18][19], one study was excluded because included patients experienced haemorrhagic and non-ischemic stroke [20], one study was not RCT [21], and one study did not compare rTMS and sham stimulation groups with each other [22]. Two articles were identified via other methods: one was found during citation searching [23] and one was found on a website [19].…”

Section: Study Selectionmentioning

confidence: 99%

Effects of High-Frequency (HF) Repetitive Transcranial Magnetic Stimulation (rTMS) on Upper Extremity Motor Function in Stroke Patients: A Systematic Review

et al. 2021

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Background and Objectives: Repetitive transcranial magnetic stimulation (rTMS) is being widely used for treating upper extremity paresis after stroke, however, evidence of applying high-frequency rTMS (HF-rTMS) on the ipsilesional hemisphere for upper extremity motor recovery remains limited. This systematic review aimed to investigate the effect of high-frequency repetitive transcranial magnetic stimulation for upper extremity motor function recovery after a first-time ischaemic stroke. Materials and Methods: This systematic review was prepared according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A comprehensive literature search was performed to identify all studies published before 12 February 2021. The search was performed on the following databases: PubMed, Ovid, The Cochrane Library. Results: A total of 6440 studies were found in the databases and four trials were included in the review. Three of the studies were randomized control trials (RCT), and one was a pseudo-RCT. Three of the studies showed good methodological quality and one study was rated as excellent. Fugl-Meyer Assessment (FMA) was performed in three out of four studies and the score significantly increased in the HF-rTMS treatment group compared with sham stimulation in all trials. Other measures used in the studies were handgrip strength, shoulder abduction, Motricity Index, Wolf Motor Function Test (WMFT), and Box and Block, although these tests did not show unanimous results. Overall, all four studies conveyed significantly better results in at least one test that was performed for hand motor function evaluation in a 10 Hz stimulation group while none of the tests showed any advantage for sham stimulation groups. Two studies reported headache as an adverse event (six patients in total). Conclusion: The overall results showed that HF-rTMS may increase impaired upper extremity motor function better than sham stimulation in stroke patients.

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“…The motor enhancement results in the LF-HF-rTMS group are more effective than those in the LF-rTMS and control groups at the end of treatment and the 3-month follow-up. Although both LF-HF and LF-HF-rTMS can promote effective recovery of upper extremity motor function in patients with acute stroke, the combination of HF-rTMS and LF-rTMS is more beneficial for improved motor function compared with LF-rTMS alone [36].…”

Section: Rtms On Motor-function Recovery After Acute Strokementioning

confidence: 94%

Promotion of Poststroke Motor-Function Recovery with Repetitive Transcranial Magnetic Stimulation by Regulating the Interhemispheric Imbalance

et al. 2020

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Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain-stimulation technique that transiently modulates cerebral cortex excitability, achieving overall positive results in poststroke motor-function recovery. Excessive inhibition of the ipsilesional-affected hemisphere by the contralesional-unaffected hemisphere has seriously hindered poststroke motor-function recovery. Hence, intracortical disinhibition can be used as an approach to managing poststroke brain injury. This technique promotes neural plasticity for faster motor-function recovery. rTMS relieves unilateral inhibition of the brain function by regulatinga interhemispheric-imbalanced inhibition. This paper summarized 12 studies from 2016 to date, focusing on rTMS on motor function after acute and chronic stroke by regulating the interhemispheric imbalance of inhibitory inputs. Although rTMS studies have shown promising outcomes on recovery of motor functions in stroke patients, different intervention methods may lead to discrepancies in results. A uniform optimal stimulus model cannot routinely be used, mainly due to the stimulus schemes, stroke types and outcome-measuring differences among studies. Thus, the effect of rTMS on poststroke motor-function recovery should be investigated further to standardize the rTMS program for optimal poststroke motor-function recovery. More randomized, placebo-controlled clinical trials with standardized rTMS protocols are needed to ensure the effectiveness of the treatment.

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Long-term effect of repetitive transcranial magnetic stimulation on disability in patients with stroke

Cited by 9 publications

References 19 publications

Can repetitive transcranial magnetic stimulation enhance motor outcomes in cerebral infarct patients?

Can repetitive transcranial magnetic stimulation enhance motor outcomes in cerebral infarct patients?

Effects of High-Frequency (HF) Repetitive Transcranial Magnetic Stimulation (rTMS) on Upper Extremity Motor Function in Stroke Patients: A Systematic Review

Promotion of Poststroke Motor-Function Recovery with Repetitive Transcranial Magnetic Stimulation by Regulating the Interhemispheric Imbalance

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