High-frequency repetitive transcranial magnetic stimulation (rTMS) over the ipsilesional primary motor area (M1) after acute unilateral stroke

Publication Reference

Guan, Y. Z., Li, J., Zhang, X. W., Wu, S., Du, H., Cui, L. Y., & Zhang, W. H. (2017). Effectiveness of repetitive transcranial magnetic stimulation (rTMS) after acute stroke: A one‐year longitudinal randomized trial. CNS neuroscience & therapeutics23(12), 940-946.

 

Article Summary*

This randomized, double-blind, sham-controlled trial investigated the effectiveness of high frequency (5Hz) rTMS applied over the ipsilesional M1 for supporting functional recovery after stroke (unilateral infarction in the middle cerebral artery territory).  This protocol was based on the theory that high frequency stimulation of the ipsilesional cortex may aid restoration of local blood flow and support neural reorganisation.  One week after stroke, patients were randomly assigned to receive active rTMS or sham (n = 13 & 14, respectively).  Functional assessments were performed pre- and post-treatment, then at 1 month, 3 months, 6 months, and 1-year follow-up.  Immediately after 10 consecutive sessions, patients in the active rTMS group showed significantly greater improvements in stroke impairment scores (National Institute of Health Stroke Scale), performance of activities of daily living (Barthel Index), and upper limb function (Fugl-Meyer Assessment) compared to sham participants.  These improvements were still evident at 1-month follow-up.  From 3 months to 1-year follow-up, the improvements in upper limb function were still significantly greater in the active rTMS group compared to the sham group.  The authors concluded that rTMS may have benefits for facilitating stroke recovery, particularly in the acute stages. No discomfort during treatment was reported by any patient.

 

*For original abstract/publication see the link below.

 

Publication link: Effectiveness of repetitive transcranial magnetic stimulation (rTMS) after acute stroke: A one‐year longitudinal randomized trial – Guan – 2017 – CNS Neuroscience & Therapeutics – Wiley Online Library