scholarly journals Peripheral magnetic theta burst stimulation to muscles can effectively reduce spasticity: a randomized controlled trial

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Nevine El Nahas ◽  
Fatma Fathalla Kenawy ◽  
Eman Hamid Abd Eldayem ◽  
Tamer M. Roushdy ◽  
Shahinaz M. Helmy ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Controlled Trial ◽  
Controlled Study ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Clinical Trial Registry ◽  
Modified Ashworth Scale ◽  
The Difference ◽  
Ashworth Scale ◽  
Theta Burst

Abstract Background Spasticity is a common complication of many neurological diseases and despite contributing much disability; the available therapeutic options are limited. Peripheral magnetic stimulation is one promising option. In this study, we investigated whether peripheral intermittent theta burst stimulation (piTBS) will reduce spasticity when applied directly on spastic muscles. Methods In this sham-controlled study, eight successive sessions of piTBS were applied directly to spastic muscles with supra threshold intensity. Assessment was done by modified Ashworth scale (mAS) and estimated Botulinum toxin dose (eBTD) at baseline and after the 8th session in both active and sham groups. Results A total of 120 spastic muscles of 36 patients were included in the analysis. Significant reduction of mAS and eBTD was found in the active compared to sham group (p < 0.001). The difference in mAS was also significant when tested in upper limb and lower limb subgroups. The degree of reduction in mAS was positively correlated with the baseline scores in the active group. Conclusion piTBS could be a promising method to reduce spasticity and eBTD. It consumes less time than standard high frequency protocols without compromising treatment efficacy. Trial registration: Clinical trial registry number: PACTR202009622405087. Retrospectively Registered 14th September, 2020.

Cerebellar Theta-Burst Stimulation Combined With Physiotherapy in Subacute and Chronic Stroke Patients: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 35 (1) ◽  
pp. 23-32
Author(s):  
Ling-Yi Liao ◽  
Yun-Juan Xie ◽  
Yi Chen ◽  
Qiang Gao
Keyword(s):  
Sham Group ◽  
Low Cost ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Stroke Patients ◽  
Clinical Trial Registry ◽  
Theta Burst

Background Intermittent theta-burst stimulation (iTBS) has been suggested to improve poststroke rehabilitation. The cerebellum is considered crucial for motor control. However, the effects of cerebellar iTBS with routine physical therapy on balance and motor recovery in subacute and chronic stroke patients have not been explored. Objective To measure the short-term effects of cerebellar iTBS with physiotherapy on the balance and functional outcomes in subacute and chronic stroke patients with hemiparesis. Methods Thirty hemiparetic patients were recruited for this randomized, double-blinded, sham-controlled trial, and randomized into either the treatment or sham group. Both groups participated in physiotherapy 5 times per week for 2 weeks, and cerebellar iTBS or sham iTBS was performed daily, immediately before physiotherapy. The primary outcome was the Berg balance scale (BBS) score. Secondary outcomes included the trunk impairment scale (TIS) score, Fugl-Meyer assessment scale score for lower extremities (FMA-LE), Barthel index (BI), and corticospinal excitability, as measured by transcranial magnetic stimulation. The outcomes were measured before and 1 week and 2 weeks after the intervention. Results Compared with those at baseline, significant increases were identified in all clinical scores (BBS, TIS, FMA-LE, and BI) in both groups after the 2-week intervention. The BBS and TIS scores improved more in the iTBS group than in the sham group. Conclusions Cerebellar iTBS with physiotherapy promotes balance and motor recovery in poststroke patients. Therefore, this method can be used in low-cost, fast, and efficient protocols for stroke rehabilitation (Chinese Clinical Trial Registry: ChiCTR1900026450).

Inhibitory theta burst stimulation of affected hemisphere in chronic stroke: A proof of principle, sham-controlled study

2013 ◽  
Vol 553 ◽  
pp. 148-152 ◽  
Author(s):  
Vincenzo Di Lazzaro ◽  
John C. Rothwell ◽  
Penelope Talelli ◽  
Fioravante Capone ◽  
Federico Ranieri ◽  
...  
Keyword(s):  
Chronic Stroke ◽  
Controlled Study ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Theta Burst ◽  
Proof Of Principle ◽  
Stimulation Of

scholarly journals Effects of priming intermittent theta burst stimulation on upper limb motor recovery after stroke: study protocol for a proof-of-concept randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e035348
Author(s):  
Jack Jiaqi Zhang ◽  
Kenneth N K Fong
Keyword(s):  
Randomised Controlled Trial ◽  
Upper Limb ◽  
Primary Motor Cortex ◽  
Controlled Trial ◽  
Sample Size Calculation ◽  
Facilitatory Effect ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Randomised Controlled ◽  
Theta Burst

IntroductionIntermittent theta burst stimulation (iTBS), a form of repetitive transcranial magnetic stimulation (rTMS), delivered to the ipsilesional primary motor cortex (M1), appears to enhance the brain’s response to rehabilitative training in patients with stroke. However, its clinical utility is highly subject to variability in different protocols. New evidence has reported that preceding iTBS, with continuous theta burst stimulation (cTBS) may stabilise and even boost the facilitatory effect of iTBS on the stimulated M1, via metaplasticity. The aim of this study is to investigate the effects of iTBS primed with cTBS (ie, priming iTBS), in addition to robot-assisted training (RAT), on the improvement of the hemiparetic upper limb functions of stroke patients and to explore potential sensorimotor neuroplasticity using electroencephalography (EEG).Methods and analysisA three-arm, subjects and assessors-blinded, randomised controlled trial will be performed with patients with chronic stroke. An estimated sample of 36 patients will be needed based on the prior sample size calculation. All participants will be randomly allocated to receive 10 sessions of rTMS with different TBS protocols (cTBS+iTBS, sham cTBS+iTBS and sham cTBS+sham iTBS), three to five sessions per week, for 2–3 weeks. All participants will receive 60 min of RAT after each stimulation session. Primary outcomes will be assessed using Fugl-Meyer Assessment-Upper Extremity scores and Action Research Arm Test. Secondary outcomes will be assessed using kinematic outcomes generated during RAT and EEG.Ethics and disseminationEthical approval has been obtained from The Human Subjects Ethics Sub-committee, University Research Committee of The Hong Kong Polytechnic University (reference number: HSEARS20190718003). The results yielded from this study will be presented at international conferences and sent to a peer-review journal to be considered for publication.Trial registration numberNCT04034069.

scholarly journals Efficacy, Safety, and Tolerability of Theta-Burst Stimulation in Mixed Depression: Design, Rationale, and Objectives of a Randomized, Double-Blinded, Sham-Controlled Trial

2020 ◽  
Vol 11 ◽  
Author(s):  
Diego Freitas Tavares ◽  
Carla Garcia Rodrigues dos Santos ◽  
Leandro Da Costa Lane Valiengo ◽  
Izio Klein ◽  
Lucas Borrione ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Design Rationale ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Double Blinded ◽  
Theta Burst
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