The Effect of Sham Controlled Continuous Theta Burst Stimulation and Low Frequency Repetitive Transcranial Magnetic Stimulation on Upper Extremity Spasticity and Functional Recovery in Chronic Ischemic Stroke Patients

2021 ◽  
Vol 30 (7) ◽  
pp. 105795
Author(s):  
Ömer Kuzu ◽  
Emre Adiguzel ◽  
Serdar Kesikburun ◽  
Evren Yaşar ◽  
Bilge Yılmaz
Keyword(s):  
Ischemic Stroke ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Stroke Patients ◽  
Theta Burst ◽  
Continuous Theta Burst Stimulation

scholarly journals Effects of low-frequency repetitive transcranial magnetic stimulation combined with cerebellar continuous theta burst stimulation on spasticity and limb dyskinesia in patients with stroke

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dawei Li ◽  
Aixia Cheng ◽  
Zhiyou Zhang ◽  
Yuqian Sun ◽  
Yingchun Liu
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Stroke Patients ◽  
Muscle Spasticity ◽  
Theta Burst ◽  
Continuous Theta Burst Stimulation

Abstract Background Repetitive transcranial magnetic stimulation (rTMS) has been reported to treat muscle spasticity in post-stroke patients. The purpose of this study was to explore whether combined low-frequency rTMS (LF-rTMS) and cerebellar continuous theta burst stimulation (cTBS) could provide better relief than different modalities alone for muscle spasticity and limb dyskinesia in stroke patients. Methods This study recruited ninety stroke patients with hemiplegia, who were divided into LF-rTMS+cTBS group (n=30), LF-rTMS group (n=30) and cTBS group (three pulse bursts at 50 Hz, n=30). The LF-rTMS group received 1 Hz rTMS stimulation of the motor cortical (M1) region on the unaffected side of the brain, the cTBS group received cTBS stimulation to the cerebellar region, and the LF-rTMS+cTBS group received 2 stimuli as described above. Each group received 4 weeks of stimulation followed by rehabilitation. Muscle spasticity, motor function of limb and activity of daily living (ADL) were evaluated by modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI) scores, respectively. Results The MAS score was markedly decreased, FMA and MBI scores were markedly increased in the three groups after therapy than before therapy. In addition, after therapy, LF-rTMS+cTBS group showed lower MAS score, higher FMA and MBI scores than the LF-rTMS group and cTBS group. Conclusion Muscle spasticity and limb dyskinesia of the three groups are all significantly improved after therapy. Combined LF-rTMS and cTBS treatment is more effective in improving muscle spasticity and limb dyskinesia of patients after stroke than LF-rTMS and cTBS treatment alone.

scholarly journals Comparison of the Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation with That of Theta Burst Stimulation on Upper Limb Motor Function in Poststroke Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Takahiro Kondo ◽  
Naoki Yamada ◽  
Ryo Momosaki ◽  
Masato Shimizu ◽  
Masahiro Abo
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Function ◽  
Upper Limb ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Performance Time ◽  
Theta Burst

Background. The purpose of this study was to evaluate the difference between the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) and that of continuous theta burst stimulation (cTBS), when each is combined with intensive occupational therapy (OT), in poststroke patients with upper limb hemiparesis. Materials and Methods. The study subjects were 103 poststroke patients with upper limb hemiparesis, who were divided into two groups: the LF-rTMS group (n=71) and the cTBS group (three pulse bursts at 50 Hz) (n=32). Each subject received 12 sessions of repetitive transcranial magnetic stimulation of 2,400 pulses applied to the nonlesional hemisphere and 240-min intensive OT (two 60-min one-to-one training sessions and two 60-min self-training exercises) daily for 15 days. Motor function was evaluated using the Fugl-Meyer Assessment (FMA) and the performance time of the Wolf motor function test (WMFT) was determined on the days of admission and discharge. Results. Both groups showed a significant increase in the FMA score and a short log performance time of the WMFT (p<0.001), but the increase in the FMA score was higher in the LF-rTMS group than the cTBS group (p<0.05). Conclusion. We recommend the use of 2400 pulses of LF-rTMS/OT for 2 weeks as treatment for hemiparetic patients.

Prolonged Continuous Theta-burst Stimulation is More Analgesic Than ‘Classical’ High Frequency Repetitive Transcranial Magnetic Stimulation

2015 ◽  
Vol 8 (1) ◽  
pp. 135-141 ◽  
Author(s):  
Xavier Moisset ◽  
Simon Goudeau ◽  
Frédérique Poindessous-Jazat ◽  
Sophie Baudic ◽  
Pierre Clavelou ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
High Frequency ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Theta Burst ◽  
Continuous Theta Burst Stimulation

The effects of 30 Hz, 50 Hz AND 100 Hz continuous theta burst stimulation via transcranial magnetic stimulation on the electrophysiological parameters in healthy individuals

2021 ◽  
Vol 74 (1-2) ◽  
pp. 41-49
Author(s):  
Zeynep Ozdemir ◽  
Erkan Acar ◽  
Aysun Soysal
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Short Interval ◽  
Motor Evoked Potential ◽  
Individual Variability ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Resting Motor Threshold ◽  
Theta Burst ◽  
Continuous Theta Burst Stimulation

Transcranial magnetic stimulation is a non-invasive procedure that uses robust magnetic fields to create an electrical current in the cerebral cortex. Dual stimulation consists of administering subthre­shold conditioning stimulation (CS), then suprathreshold test stimulation (TS). When the interstimulus interval (ISI) is 1-6 msec, the motor evoked potential (MEP) decreases in amplitude; this decrease is termed “short interval intracortical inhibition” (SICI); when the ISI is 7-30 msec, an increase in MEP amplitude occurs, termed “short interval intracortical facilitation” (SICF). Continuous theta burst stimulation (cTBS), often applied at a frequency of 50 Hz, has been shown to decrease cortical excitability. The primary objective is to determine which duration of cTBS achieves better inhibition or excitation. The secondary objective is to compare 50 Hz cTBS to 30 Hz and 100 Hz cTBS. The resting motor threshold (rMT), MEP, SICI, and SICF were studied in 30 healthy volunteers. CS and TS were administered at 80%-120% and 70%-140% of rMT at 2 and 3-millisecond (msec) intervals for SICI, and 10- and 12-msec intervals for SICF. Ten individuals in each group received 30, 50, or 100 Hz, followed by administration of rMT, MT-MEP, SICI, SICF immediately and at 30 minutes. Greater inhibition was achieved with 3 msec than 2 msec in SICI, whereas better facilitation occurred at 12 msec than 10 msec in SICF. At 30 Hz, cTBS augmented inhibition and suppressed facilitation, while 50 Hz yielded less inhibition and greater inter-individual variability. At 100 Hz, cTBS provided slight facilitation in MEP amplitudes with less interindividual variability. SICI and SICF did not differ significantly between 50 Hz and 100 Hz cTBS. Our results suggest that performing SICI and SICF for 3 and 12 msec, respectively, and CS and TS at 80%-120% of rMT, demonstrate safer inhibition and facilitation. Recently, TBS has been used in the treatment of various neurological diseases, and we recommend preferentially 30 Hz over 50 Hz cTBS for better inhibition with greater safety and less inter-individual variability.

scholarly journals Selecting stimulation intensity in repetitive transcranial magnetic stimulation studies: A systematic review between 1991 and 2020

2020 ◽  
Author(s):  
Zsolt Turi ◽  
Maximilian Lenz ◽  
Walter Paulus ◽  
Matthias Mittner ◽  
Andreas Vlachos
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Basic Science ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Sufficient Information ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Stimulation Intensity ◽  
Theta Burst

AbstractBackgroundRepetitive transcranial magnetic stimulation (rTMS) is an increasingly used, non-invasive brain stimulation technique in neuroscience research and clinical practice with a broad spectrum of suggested applications. Among other parameters, the choice of stimulus intensity and intracranial electric field strength substantially impact rTMS outcome. This review provides a systematic overview of the intensity selection approaches and stimulation intensities used in human rTMS studies. We also examined whether studies report sufficient information to reproduce stimulus intensities in basic science research models. Methods. We performed a systematic review by focusing on original studies published between 1991 and 2020. We included conventional (e.g., 1 Hz or 10 Hz) and patterned protocols (e.g., continuous or intermittent theta burst stimulation). We identified 3,784 articles in total, and we manually processed a representative portion (20%) of randomly selected articles. Results. The majority of the analyzed studies (90% of entries) used the motor threshold (MT) approach and stimulation intensities from 80 to 120% of the MT. For continuous and intermittent theta burst stimulation, the most frequent stimulation intensity was 80% of the active MT. Most studies (92% of entries) did not report sufficient information to reproduce the stimulation intensity. Only a minority of studies (1.03% of entries) estimated the rTMS-induced electric field strengths. Conclusion. We formulate easy-to-follow recommendations to help scientists and clinicians report relevant information on stimulation intensity. Future standardized reporting guidelines may facilitate the use of basic science approaches aiming at better understanding the molecular, cellular, and neuronal mechanisms of rTMS.

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