Repetitive Transcranial Magnetic Stimulation (rTMS) for the Improvement of Upper Limb Function in Stroke Patients

2018 ◽  
pp. 678-681
Author(s):  
Luca Sebastianelli ◽  
Viviana Versace ◽  
Raffaele Nardone ◽  
Leopold Saltuari
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Upper Limb ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Stroke Patients ◽  
Limb Function ◽  
Upper Limb Function

scholarly journals Effects of Excitatory Transcranial Magnetic Stimulation of the Anterior Intraparietal Area in Chronic Stroke Patients

2018 ◽  
Author(s):  
Ronaldo Luis da Silva ◽  
Angela Maria Costa de Souza ◽  
Francielly Ferreira Santos ◽  
Sueli Toshie Inoue ◽  
Johanne Higgins ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Magnetic Stimulation ◽  
Sensory Function ◽  
Stroke Patients ◽  
Chronic Patients ◽  
Upper Limb Function ◽  
Stimulation Of

1) Objective: to evaluate the effects of excitatory transcranial magnetic stimulation of the anterior intraparietal area in chronic patients with a frontal lesion and parietal sparing due to stroke on the impaired upper (UL) and lower limb (LL) as measured by Fugl-Meyer Assessment (FMA). 2) Methods: three patients (P1: 49.83/2.75, P2: 53.17/3.83, P3:63.33/3.08 years-old at stroke/years post-stroke, respectively) received two weeks (five days/ week) of rTMS at 10 Hz of the left anterior intraparietal area (AIP). A patient was treated in similar conditions with a sham coil (56.58/4.33) No complimentary therapy was delivered during the study. Patients were evaluated before, after- and two-months post-treatment (A1, A2 and A3, respectively). 3) Results: We found increased scores for lower limb in motor function subsection for P1 and P3 and in sensory function for P2 by A2 that remained at A3. We also found an increased score for upper limb motor function for P2 and P3, but the score decreased by A3 for P2. P3 score for upper limb ROM increased by A3 compared to A1 and A2. 4) Conclusion: AIP excitatory rTMS increased the FMA scores for lower and upper limb function, showing a broader effect when compared to M1 stimulation.

scholarly journals Does Transcranial Magnetic Stimulation Have an Added Value to Clinical Assessment in Predicting Upper-Limb Function Very Early After Severe Stroke?

2018 ◽  
Vol 32 (8) ◽  
pp. 682-690 ◽  
Author(s):  
Maurits H. J. Hoonhorst ◽  
Rinske H. M. Nijland ◽  
Peter J. S. van den Berg ◽  
Cornelis H. Emmelot ◽  
Boudewijn J. Kollen ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Upper Limb ◽  
Predictive Value ◽  
Magnetic Stimulation ◽  
Prognostic Value ◽  
Motor Evoked Potentials ◽  
Added Value ◽  
Shoulder Abduction ◽  
Limb Function ◽  
Upper Limb Function

Background. The added prognostic value of transcranial magnetic stimulation (TMS)-induced motor-evoked potentials (MEPs) to clinical modeling for the upper limb is still unknown early poststroke. Objective. To determine the added prognostic value of TMS of the adductor digiti minimi (TMS-ADM) to the clinical model based on voluntary shoulder abduction (SA) and finger extension (FE) during the first 48 hours and at 11 days after stroke. Methods. This was a prospective cohort study with 3 logistic regression models, developed to predict upper-limb function at 6 months poststroke. The first model showed the predictive value of SA and FE measured within 48 hours and at 11 days poststroke. The second model included TMS-ADM, whereas the third model combined clinical and TMS-ADM information. Differences between derived models were tested with receiver operating characteristic curve analyses. Results. A total of 51 patients with severe, first-ever ischemic stroke were included. Within 48 hours, no significant added value of TMS-ADM to clinical modeling was found ( P = .369). Both models suffered from a relatively low negative predictive value within 48 hours poststroke. TMS-ADM combined with SA and FE (SAFE) showed significantly more accuracy than TMS-ADM alone at 11 days poststroke ( P = .039). Conclusion. TMS-ADM showed no added value to clinical modeling when measured within first 48 hours poststroke, whereas optimal prediction is achieved by SAFE combined with TMS-ADM at 11 days poststroke. Our findings suggest that accuracy of predicting upper-limb motor function by TMS-ADM is mainly determined by the time of assessment early after stroke onset.

scholarly journals Comparison of Repetitive Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation on Upper Limb Recovery Among Patients With Recent Stroke

2020 ◽  
Vol 44 (6) ◽  
pp. 428-437
Author(s):  
Ka Ying Doris Miu ◽  
Ching Kok ◽  
Sau Shan Leung ◽  
Elaine Y. L. Chan ◽  
Elaine Wong
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Upper Limb ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Motor Performance ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Direct Current Stimulation ◽  
Upper Limb Function ◽  
Significant Difference

Objective To compare the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on upper limb function recovery among patients who recently had stroke.Methods Subjects with recent stroke (within 1 month) were randomized to rTMS (n=25) and tDCS (n=26) applied over the non-lesioned hemisphere for three sessions per week, followed by tailored upper limb rehabilitation training for a total of 2 weeks. The primary outcomes were changes in the Motor Assessment Scale (MAS), Fugl-Meyer arm score test, Nine-Hole Peg Test (9HPT), hand grip strength, and modified Barthel Index at weeks 2 and 4. Both therapists responsible for training and assessment were blinded to the intervention allocated.Results There was an improvement in all the motor performance scales among both groups (p<0.001). These improvements persisted at discharge. However, there was no significant difference in any of the assessment scales between the two groups. The rTMS group showed a statistically non-significant greater improvement in MAS, 9HPT, and handgrip strength than the tDCS group.Conclusion Both interventions produce a statistically significant improvement in upper limb function. There was no statistically significant difference between the two intervention methods with respect to motor performance. It is suggested that a larger study may help to clarify the superiority of either methods.

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