The Effectiveness of 1Hz rTMS Over the Primary Motor Area of the Unaffected Hemisphere to Improve Hand Function After Stroke Depends on Hemispheric Dominance

Lüdemann-Podubecká, Jitka; Bösl, Kathrin; Theilig, Steven; Wiederer, Ralf; Nowak, Dennis A.

doi:10.1016/j.brs.2015.02.004

Cited by 62 publications

(69 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar findings were reported with bihemispheric stimulation for a simple reaction time task (O'Shea et al , 2014) and for the change in motor function after three weeks of repetitive TMS to the contralesional M1 (Ludemann-Podubecka et al , 2015). The explanation for this hemispheric difference may lie in the susceptibility of M1 to adapt.…”

Section: Discussionsupporting

confidence: 80%

P244 The effect of transcranial direct current stimulation on motor sequence learning and upper limb function after stroke

Fleming

Rothwell

Sztriha

et al. 2017

Clinical Neurophysiology

View full text Add to dashboard Cite

. (2017). P244 The effect of transcranial direct current stimulation on motor sequence learning and upper limb function after stroke. CLINICAL NEUROPHYSIOLOGY, 128(3), e133. DOI: 10.1016DOI: 10. /j.clinph.2016 Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policyIf you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access to the work immediately and investigate your claim. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.  Improvement in the Jebsen Taylor Test was seen after unilateral motor cortex tDCS but not after bihemispheric motor cortex tDCS. Changes in performance with tDCS were independent of changes in transcallosal inhibition. AbstractObjective: To assess the impact of electrode arrangement on the efficacy of tDCS in stroke survivors and determine whether changes in transcallosal inhibition (TCI) underlie improvements.Methods: 24 stroke survivors (3-124 months post-stroke) with upper limb impairment participated. They received blinded tDCS during a motor sequence learning task, requiring the paretic arm to direct a cursor to illuminating targets on a monitor. Four tDCS conditions were studied (crossover); anodal to ipsilesional M1, cathodal to contralesional M1, bihemispheric, sham. The Jebsen Taylor hand function test (JTT) was assessed pre-and poststimulation and TCI assessed as the ipsilateral silent period (iSP) duration using transcranial magnetic stimulation. Results:The time to react to target illumination reduced with learning of the movement se...

show abstract

Section: Discussionsupporting

confidence: 80%

P244 The effect of transcranial direct current stimulation on motor sequence learning and upper limb function after stroke

Fleming

Rothwell

Sztriha

et al. 2017

Clinical Neurophysiology

View full text Add to dashboard Cite

show abstract

“…Those discussed are randomized, blinded, sham-controlled, and have well-matched study groups; importantly, they also use measures believed to best read out neural reorganization (e.g., strength, UE-FM score) [44]. 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

View full text Add to dashboard Cite

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.

show abstract

“…The goal of this study was to examine changes in cortical excitability and motor areas as well as motor behavioral parameters throughout the intervention over both hemispheres. According to the previously described studies in patients, [3][4][5]7,10 we hypothesized a decrease in excitability over the stimulated hemisphere and an increase over the nonstimulated hemisphere. Additionally, we sought to determine an optimal length of the intervention by identifying plateaus of potential improvements as well as possible impacts of hemispheric dominance on these effects.…”

Section: Introductionmentioning

confidence: 99%

“…The inclusion of healthy subjects necessitates careful consideration toward which hemisphere receives the treatment because there is no natural distinction due to a lesion. In stroke patients, it was suggested that hemispheric dominance may influence the outcome of the rTMS intervention, 10 although it has not yet been investigated in healthy subjects.…”

Section: Introductionmentioning

confidence: 99%

1 Hz Repetitive Transcranial Magnetic Stimulation of the Primary Motor Cortex: Impact on Excitability and Task Performance in Healthy Subjects

Engelhardt

Picht

2020

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

Objective Neuronavigated repetitive transcranial stimulation (rTMS) at a frequency of 1 Hz was shown to reduce excitability in underlying brain areas while increasing excitability in the opposite hemisphere. In stroke patients, this principle is used to normalize activity between the lesioned and healthy hemispheres and to facilitate rehabilitation. However, standardization is lacking in applied protocols, and there is a poor understanding of the underlying physiologic mechanisms. Furthermore, the influence of hemispheric dominance on the intervention has not been studied before. A systematic evaluation of the effects in healthy subjects would deepen the understanding of these mechanisms and offer insights into ways to improve the intervention. Methods Twenty healthy subjects underwent five 15-minute sessions of neuronavigated rTMS or sham stimulation over their dominant or nondominant motor cortex. Dominance was assessed with the Edinburgh Handedness Inventory. Changes in both hemispheres were measured using behavioral parameters (finger tapping, grip force, and finger dexterity) and TMS measures (resting motor threshold, recruitment curve, motor area, and cortical silent period). Results All subjects tolerated the stimulation well. A pronounced improvement was noted in finger tapping scores over the nonstimulated hemisphere as well as a nonsignificant reduction of the cortical silent period in the stimulated hemisphere, indicating a differential effect of the rTMS on both hemispheres. Grip force remained at the baseline level in the rTMS group while decreasing in the sham group, suggesting the rTMS counterbalanced the effects of fatigue. Lastly, dominance did not influence any of the observed effects. Conclusions This study shows the capability of the applied low-frequency rTMS protocol to modify excitability of underlying brain areas as well as the contralateral hemisphere. It also highlights the need for a better understanding of underlying mechanisms and the identification of predictors for responsiveness to rTMS. However, results should be interpreted with caution because of the small sample size.

show abstract

The Effectiveness of 1Hz rTMS Over the Primary Motor Area of the Unaffected Hemisphere to Improve Hand Function After Stroke Depends on Hemispheric Dominance

Cited by 62 publications

References 25 publications

P244 The effect of transcranial direct current stimulation on motor sequence learning and upper limb function after stroke

P244 The effect of transcranial direct current stimulation on motor sequence learning and upper limb function after stroke

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

1 Hz Repetitive Transcranial Magnetic Stimulation of the Primary Motor Cortex: Impact on Excitability and Task Performance in Healthy Subjects

Contact Info

Product

Resources

About