The effects of rTMS on motor recovery after stroke: a systematic review of fMRI studies

Tang, Zhiqing; Liu, Tianhao; Han, Kaiyue; Liu, Ying; Su, Wenlong; Wang, Rongrong; Zhang, Hao

doi:10.1007/s10072-023-07123-x

Cited by 2 publications

(1 citation statement)

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“…It is crucial to recognize that the principle underlying TMS stimulation is rooted in the lateralization of motor control, where the modulation of neuronal activity in specific brain regions via TMS seeks to rebalance this altered hemispheric excitability, paving the way for enhanced neural recovery and rehabilitation (Feng et al., 2023; Liepert, 2005; Miniussi & Rossini, 2011; Yuan et al., 2020). These excitability alterations might serve as a significant impediment to functional recovery (de Freitas Zanona et al., 2022; Starosta et al., 2022; Tang et al., 2023). Hence, a plausible strategy for those rehabilitation is to modulate plasticity via repetitive TMS (rTMS), aiming to restore normal activity patterns (Chen et al., 2022; Fisicaro et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Neural correlates of fine motor grasping skills: Longitudinal insights into motor cortex activation using fNIRS

Li,

Jin,

Zhang

et al. 2024

Brain and Behavior

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BackgroundMotor learning is essential for performing specific tasks and progresses through distinct stages, including the rapid learning phase (initial skill acquisition), the consolidation phase (skill refinement), and the stable performance phase (skill mastery and maintenance). Understanding the cortical activation dynamics during these stages can guide targeted rehabilitation interventions.MethodsIn this longitudinal randomized controlled trial, functional near‐infrared spectroscopy was used to explore the temporal dynamics of cortical activation in hand‐related motor learning. Thirty‐one healthy right‐handed individuals were randomly assigned to perform either easy or intricate motor tasks with their non‐dominant hand over 10 days. We conducted 10 monitoring sessions to track cortical activation in the right hemisphere (according to lateralization principles, the primary hemisphere for motor control) and evaluated motor proficiency concurrently.ResultsThe study delineated three stages of nondominant hand motor learning: rapid learning (days 1 and 2), consolidation (days 3–7), and stable performance (days 8–10). There was a power‐law enhancement of motor skills correlated with learning progression. Sustained activation was observed in the supplementary motor area (SMA) and parietal lobe (PL), whereas activation in the right primary motor cortex (M1R) and dorsolateral prefrontal cortex (PFCR) decreased. These cortical activation patterns exhibited a high correlation with the augmentation of motor proficiency.ConclusionsThe findings suggest that early rehabilitation interventions, such as transcranial magnetic stimulation and transcranial direct current stimulation (tDCS), could be optimally directed at M1 and PFC in the initial stages. In contrast, SMA and PL can be targeted throughout the motor learning process. This research illuminates the path for developing tailored motor rehabilitation interventions based on specific stages of motor learning.NEW and NOTEWORTHYIn an innovative approach, our study uniquely combines a longitudinal design with the robustness of generalized estimating equations (GEEs). With the synergy of functional near‐infrared spectroscopy (fNIRS) and the Minnesota Manual Dexterity Test (MMDT) paradigm, we precisely trace the evolution of neural resources during complex, real‐world fine‐motor task learning. Centering on right‐handed participants using their nondominant hand magnifies the intricacies of right hemisphere spatial motor processing. We unravel the brain's dynamic response throughout motor learning stages and its potent link to motor skill enhancement. Significantly, our data point toward the early‐phase rehabilitation potential of TMS and transcranial direct current stimulation on the M1 and PFC regions. Concurrently, SMA and PL appear poised to benefit from ongoing interventions during the entire learning curve. Our findings carve a path for refined motor rehabilitation strategies, underscoring the importance of timely noninvasive brain stimulation treatments.

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