Recovery of motor disability and spasticity in post-stroke after repetitive transcranial magnetic stimulation (rTMS)

Málly, Judit; Dinya, Elek

doi:10.1016/j.brainresbull.2007.11.019

Cited by 115 publications

(84 citation statements)

References 60 publications

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“…The 3 Hz stimulation showed a more pronounced effect than 10 Hz stimulation assessed by NIHSS after one year [27]. The best results were achieved after 1 Hz stimulation [28] which induced new movement in the paretic hand years after the onset of stroke [29]. A meta-analysis confirmed that 1 Hz rTMS over the unaffected hemisphere may be more beneficial for the motor outcome than the high frequency rTMS over the affected hemisphere [30].…”

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confidence: 80%

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

2014

Int J Neurorehabilitation Eng

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Two non-invasive brain stimulations have spread all over the world: repetitive trasncranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). TMS is based on the current induction with a changing electromagnetic field in the nervous system [1] while tDCS changes the polarity of cell membranes [2]. General Aspects of TMS and tDCSTMS is widely used in research and daily medical practice. It was introduced as a diagnostic tool about thirty years ago to test functioning of motor pathways [3]. The motor evoked potential (MEP) and the measurement of the central motor conduction time (CMCT) has entered into daily practice. The other parameters of the electrophysiological examination assessed by TMS are mainly used in scientific work [4]. TMS aids the diagnosis of multiple sclerosis, furthermore the prognosis of stroke can be indicated by TMS [5]. Different paired pulse stimulations with TMS give a new insight into the function of the brain. In recent years, sophisticated brain plasticity can be detected by the measurement of intracortical excitability [6,7]. We learnt from these studies how different conditions can modify brain plasticity. It can be changed by different diseases, altered by drugs [8] and strongly influenced by non-invasive stimulations [2,9]. The single TMS and one session of repetitive stimulation have a short after-effect. However the effect of repeated stimulation for days exceeds the stimulation period and many times it lasts for months. This effect of rTMS has made it useful for therapy for the last 20 years. The low and high frequency stimulation, continuous theta burst stimulation (cTBS), intermittent theta burst stimulation (iTBS), anodal or cathodal stimulation are used for therapy. The intensity of rTMS was around the motor threshold and the duration of stimulation was 7-10 days. This paper reviews the most frequently studied symptoms of Parkinson's diseases and stroke although rTMS has been tried to treat all disorders of the central nervous system (CNS). Parkinson's Disease (PD)The first protocol was low frequency, low intensity monophasic stimulation for 7 days which improved the Parkinsonian symptoms and its results were maintained for several months after the stimulation [10,11]. The authors performed a "dose (intensity) response" curve with 1 Hz stimulation and they indicated that there is an optimal intensity using 1 Hz [12]. We learned from these studies that the therapeutic effect of rTMS develops after a delay in time of a few weeks. The improvement can be maintained for several months. The later studies confirmed these observations not only in PD but other diseases. Although, the high frequency stimulations over the primary motor cortex [13,14] had the same effect on the Parkinsonian scores but the after-effect lasted for a shorter time. iTBS over the dorsolateral prefrontal area improved the depression without effecting on bradykinesia [15]. The studies concentrated on varying the frequency which was applied but they did not try to find the optimal in...

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confidence: 80%

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

2014

Int J Neurorehabilitation Eng

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“…We conducted high frequency repetitive transcranial magnetic stimulation to cerebral cortex of experimental group and as a result, MFT score of experimental group showed significant difference from the control group. Mally & Dinya [27] identified that rTMS application have a good effect on motor improvement of stroke patients.…”

Section: Discussionmentioning

confidence: 99%

Repetitive Transcranial Magnetic Stimulation Combined with Task Oriented Training to Improve Upper Extremity Function After Stroke

Kim¹

2014

Journal of Magnetics

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The purpose of the present study was to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) in conjunction with task oriented training, on cortical excitability and upper extremity function recovery in stroke patients. This study was conducted with 31 subjects who were diagnosed as a hemiparesis by stroke. Participants in the experimental (16 members) and control groups (15 members) received rTMS and sham rTMS, respectively, during a 10 minutes session, five days per week for four weeks, followed by task oriented training during a 30 minutes session, five days per week for four weeks. Motor cortex excitability was performed by motor evoked potential and upper limb function was evaluated by motor function test. Both groups showed a significant increment in motor function test and amplitude, latency in motor evoked potential compared to pre-intervention (p < 0.05). A significant difference in post-training gains for the motor function test, amplitude in motor evoked potential was observed between the experimental group and the control group (p < 0.05). The findings of the current study demonstrated that incorporating rTMS in task oriented training may be beneficial in improving the effects of stroke on upper extremity function recovery.

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“…Valle et al (23) showed that there was a significant reduction in spasticity after multiple sessions of 5-Hz rTMS, but not 1-Hz. Mally & Dinya (24) showed that multiple sessions of 1-Hz rTMS using a circular coil significantly reduced the spasticity of affected limbs in chronic stroke patients. Kondo et al (25) reported that a single session of 1-Hz rTMS significantly decreased the F/M ratio in affected upper limbs.…”

Section: Discussionmentioning

confidence: 99%

Effects of repetitive trascranial magnetic stimulation on repetitive facilitation exercises of the hemiplegic hand in chronic stroke patients

Etoh

Noma²,

Ikeda³

et al. 2013

J Rehabil Med

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Recovery of motor disability and spasticity in post-stroke after repetitive transcranial magnetic stimulation (rTMS)

Cited by 115 publications

References 60 publications

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

Repetitive Transcranial Magnetic Stimulation Combined with Task Oriented Training to Improve Upper Extremity Function After Stroke

Effects of repetitive trascranial magnetic stimulation on repetitive facilitation exercises of the hemiplegic hand in chronic stroke patients

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