Abstract 123: Effects Of High-frequency RTMS Applied Over Bilateral Leg Motor Areas Using A Double Cone Coil On Walking Function In Post-stroke Patients

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Wataru Kakuda ◽  
Masahiro Abo ◽  
Ryo Momosaki
Keyword(s):  
High Frequency ◽  
Sham Group ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Double Cone ◽  
Anatomical Location ◽  
Cost Index ◽  
Magnetic Current ◽  
Post Stroke ◽  
Walking Velocity ◽  
Motor Areas

Objective: It is difficult to stimulate leg motor areas with magnetic current using a figure-of-eight coil due to the deep anatomical location of the areas. However, a double cone coil is useful for stimulating deep brain regions. We postulated that the use of the same coil may allow repetitive transcranial magnetic stimulation (rTMS) to modulate the neural activity of the same areas. The purpose of this study is to investigate the effect of high-frequency rTMS applied over bilateral leg motor areas with a double cone coil on walking function after stroke. Materials and methods: Eighteen post-stroke hemiparetic patients with gait disturbances attended two experimental sessions with more than 24 hours apart, in a cross-over, double-blind paradigm. In one session, high-frequency rTMS of 10 Hz was applied over the leg motor area bilaterally in a 10-sec train using a double cone coil for 20 minutes (total 2,000 pulses). In the other session, sham stimulation was applied for 20 minutes at the same site. To assess walking function, walking velocity and Physiological Cost Index (PCI) were evaluated serially before, immediately after, and 10 and 20 minutes after each intervention. Results: The walking velocity was significantly higher for 20 minutes after stimulation in the high-frequency rTMS group than the sham group. PCI was lower in the high-frequency rTMS group than the sham group, but this was significant only immediately after stimulation. Conclusions: High-frequency rTMS of bilateral motor areas using a double cone coil can potentially improve walking function in post-stroke hemiparetic patients.

Randomized, proof-of-principle clinical trial of active transcranial magnetic stimulation in chronic migraine

Cephalalgia ◽  
2013 ◽  
Vol 34 (6) ◽  
pp. 464-472 ◽  
Author(s):  
Adriana B Conforto ◽  
Edson Amaro ◽  
André L Gonçalves ◽  
Juliane PP Mercante ◽  
Vera Z Guendler ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Transcranial Magnetic Stimulation ◽  
Chronic Migraine ◽  
High Frequency ◽  
Magnetic Stimulation ◽  
Sham Group ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Placebo Response ◽  
Double Blind ◽  
Proof Of Principle

Background High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex (rTMS-DLPFC) is an effective treatment for depression. Preliminary studies indicated beneficial effects of rTMS-DLPFC on pain relief in patients treated for depression, and in patients with chronic migraine. Methods In this randomized, double-blind, parallel-group, single-center, proof-of-principle clinical trial, we tested the hypothesis that 23 sessions of active rTMS-DLPFC delivered over eight weeks would be feasible, safe and superior to sham rTMS to decrease the number of headache days in 18 patients with chronic migraine without severe depression. Per-protocol analysis was performed. Results rTMS-DLPFC applied over eight weeks was feasible and safe in patients with chronic migraine. Contrary to our primary hypothesis, the number of headache days decreased significantly more in the sham group than in the group treated with active rTMS-DLPFC at eight weeks. Average decrease in headache days was >50% in the sham group, indicating a powerful placebo response. Pain intensity improved in both groups to a similar extent. Conclusions Positive results of M1 stimulation in other studies, and the absence of significant benefits of active high-frequency rTMS of the DLPFC in the present study, point to M1 as a more promising target than the DLPFC, for larger trials of noninvasive brain stimulation in patients with chronic migraine.

scholarly journals High-frequency rTMS with two different inter-train intervals improves upper limb motor function at the early stage of stroke

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092873 ◽  
Author(s):  
Jiaqia Ke ◽  
Xiaopei Zou ◽  
Mei Huang ◽  
Qiaotian Huang ◽  
Hongzhan Li ◽  
...  
Keyword(s):  
Therapeutic Effect ◽  
Motor Function ◽  
Upper Limb ◽  
High Frequency ◽  
Sham Group ◽  
Cortical Excitability ◽  
Early Period ◽  
Cortical Region ◽  
Post Stroke ◽  
Significant Difference

Objective This study aimed to explore the therapeutic effect of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) with two different inter-train intervals (ITIs) on upper limb motor function in the early period of stroke. Methods We recruited 48 post-stroke patients in the early period and randomly divided them into three cohorts: the sham group, the short ITI (8 s) group, and the long ITI (28 s) group. HF-rTMS was delivered at 20 Hz. The amplitude of motor evoked potentials at the affected cortical region, representing the abductor pollicis brevis muscle, reflected cortical excitability. At baseline, immediately after treatment, and 1 month after treatment, we evaluated the recovery of upper limb motor function using Brunnstrom recovery stages (BRSs) and the Fugl–Meyer Assessment for upper extremity (FMA-UE), and assessed functional independence using the Barthel Index (BI). Results HF-rTMS with two different ITIs significantly improved upper limb functional recovery relative to the sham group, but there was no significant difference in cortical excitability changes or BRS, FMA-UE, or BI scores between the different ITI groups. Conclusions At the early post-stroke stage, HF-rTMS with short ITIs generates a similar therapeutic effect to HF-rTMS with long ITIs, suggesting that treatment times can be decreased.

Therapy of post-stroke depression – a systematic review

2013 ◽  
Vol 10 (02) ◽  
pp. 108-129 ◽  
Author(s):  
W. Gaebel ◽  
W. Wannagat ◽  
J. Zielasek
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Placebo Control ◽  
Post Stroke ◽  
Pharmacological Studies ◽  
Post Stroke Depression ◽  
Control Procedures ◽  
Antidepressant Pharmacotherapy

SummaryWe performed a systematic review of randomized placebo-controlled pharmacological and non-pharmacological trials for the therapy and prevention of post-stroke depression that have been published between 1980 and 2011. We initially identified 2 260 records of which 28 studies were finally included into this review. A meta-analytic approach was hampered by considerable differences regarding the kinds of therapeutic regimens and the study durations. Modest effects favoring treatment of post-stroke depression could be found for pharmacological treatment as well as repetitive transcranial magnetic stimulation. For the prevention of post-stroke depression, antidepressant pharmacotherapy showed promising results. However, large-scale studies with better standardized study populations, optimized placebo control procedures in non-pharmacological studies, and replication in larger follow-up studies are still necessary to find the optimal therapeutic regimens to prevent and treat post-stroke depression.

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