scholarly journals Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients

2018 ◽  
Vol 25 (2) ◽  
pp. 116-125 ◽  
Author(s):  
Muhammad Hafiz Hanafi ◽  
◽  
Nur Karyatee Kassim ◽  
Al Hafiz Ibrahim ◽  
Munirah Mohd Adnan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Stroke Patients ◽  
Cortical Modulation

scholarly journals PENGARUH REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS) TERHADAP GANGGUAN FUNGSI KOGNITIF PASCASTROKE ISKEMIK

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Novika Azirah Azis ◽  
Jumraini Tammasse ◽  
Abdul Muis
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Transcranial Magnetic Stimulation ◽  
Treatment Group ◽  
Medical Therapy ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Stroke Patients ◽  
Chi Square

  THE INFLUENCE OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS) TOWARDS IMPAIRED COGNITIVE FUNCTION AFTER ISCHEMIC STROKEABSTRACTIntroduction: The increasing number of ischemic stroke patients who experience memory disturbances and a long rehabilitation process requires an innovation that can strengthen both existing therapies (medical therapy) and non-invasive stimulation of cognitive rehabilitation in the form of repetitive transcranial magnetic stimulation (rTMS).Aim: To determine effectiveness of rTMS towards impaired cognitive function in ischemic stroke.Methods: This research was conducted using experimental with open clinical trial test method  on ischemic stroke patients suffering from cognitive impairment at Wahidin Sudirohusodo Hospital and Inggit Clinic, Makassar, from November 2018 until January 2019. Samples were divided into control who was given only medical therapy and treatment group who was given medical therapy and rTMS. Stimulation is given in the form of a high frequency of 10Hz in 2 cycles for 5 consecutive days with a gap of 2 days. MoCA-Ina was used to assess cognitive impairment. The assessment were made on day-1 before therapy and day-15 after therapy. The statistical analysis of correlation among variables was conducted by using Chi-square test with value of p <0.05 which was considered significant.Results: There were 22 samples, 11 in each group. The difference of MoCA-Ina scores in both groups with the final average after 15 days of treatment was 5.27 in the treatment group and 1.45 in control group. This difference is considered significant with the p value of 0.003.Discussion: There was an effect of rTMS therapy on cognitive function disorders after ischemic stroke, in which the change was greater in the treatment group than in the control group.Keywords: Cognitive impairment, ischemic stroke, Montreal Cognitive Assesment Indonesian Version (MoCA-Ina), repetitive transcranial magnetic stimulation (rTMS)ABSTRAKPendahuluan: Peningkatan jumlah pasien stroke iskemik yang mengalami gangguan memori serta proses rehabilitasi yang lama membutuhkan suatu inovasi yang dapat saling menguatkan antara terapi yang sudah ada (terapi medik) dan stimulasi non-invasif rehabilitasi kognitif berupa repetitive transcranial magnetic stimulation (rTMS).Tujuan: Mengetahui pengaruh intervensi rTMS terhadap fungsi kognitif pascastroke iskemik.Metode: Penelitian eksperimental dengan uji klinis terbuka terhadap pasien stroke iskemik yang menderita gangguan fungsi kognitif di RSUP Dr. Wahidin Sudirohusodo dan Klinik Inggit Medika, Makassar, pada bulan November 2018 hingga Januari 2019. Subjek dibagi ke dalam kelompok kontrol yang diberikan terapi medikamentosa saja serta kelompok perlakuan yang diberikan terapi medikamentosa dan intervensi rTMS. Stimulasi diberikan berupa frekuensi tinggi 10Hz dalam 2 siklus selama 5 hari berturut-turut dengan jeda waktu 2 hari. Penilaian gangguan kognitif menggunakan Montreal Cognitive Assesment versi Indonesia (MoCA-Ina). Pengukuran dilakukan pada hari-1 pre-terapi dan hari ke-15 pascaterapi. Data dianalisis secara statistik menggunakan uji Chi-square dengan nilai p<0,05 dianggap bermakna.Hasil: Terdapat 22 subjek yang masing-masing terdiri dari 11 subjek pada kelompok kontrol dan perlakuan. Selisih skor MoCA-Ina pada kedua kelompok dengan rerata akhir setelah lima belas hari perlakuan sebesar 5,27 pada kelompok perlakuan dan 1,45 pada kelompok kontrol yang bermakna (p=0,003).Diskusi: Terdapat pengaruh terapi rTMS terhadap gangguan fungsi kognitif pascastroke yang lebih besar pada kelompok perlakuan dibanding kelompok kontrol.Kata kunci: Gangguan kognitif, Montreal Cognitive Assesment versi Indonesia (MoCA-Ina), repetitive transcranial magnetic stimulation (rTMS), stroke iskemik  

scholarly journals Efficacy of repetitive transcranial magnetic stimulation combined with visual scanning treatment on cognitive and behavioral symptoms of left hemispatial neglect in right hemispheric stroke patients: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Francesco Di Gregorio ◽  
Fabio La Porta ◽  
Emanuela Casanova ◽  
Elisabetta Magni ◽  
Roberta Bonora ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Hemispatial Neglect ◽  
Visual Scanning ◽  
Stroke Patients ◽  
Rehabilitation Protocol ◽  
Randomized Controlled

Abstract Background Left hemispatial neglect (LHN) is a neuropsychological syndrome often associated with right hemispheric stroke. Patients with LHN have difficulties in attending, responding, and consciously representing the right side of space. Various rehabilitation protocols have been proposed to reduce clinical symptoms related to LHN, using cognitive treatments, or on non-invasive brain stimulation. However, evidence of their benefit is still lacking; in particular, only a few studies focused on the efficacy of combining different approaches in the same patient. Methods In the present study, we present the SMART ATLAS trial (Stimolazione MAgnetica Ripetitiva Transcranica nell’ATtenzione LAteralizzata dopo Stroke), a multicenter, randomized, controlled trial with pre-test (baseline), post-test, and 12 weeks follow-up assessments based on a novel rehabilitation protocol based on the combination of brain stimulation and standard cognitive treatment. In particular, we will compare the efficacy of inhibitory repetitive-transcranial magnetic stimulation (r-TMS), applied over the left intact parietal cortex of LHN patients, followed by visual scanning treatment, in comparison with a placebo stimulation (SHAM control) followed by the same visual scanning treatment, on visuospatial symptoms and neurophysiological parameters of LHN in a population of stroke patients. Discussion Our trial results may provide scientific evidence of a new, relatively low-cost rehabilitation protocol for the treatment of LHN. Trial registration ClinicalTrials.gov NCT04080999. Registered on September 2019.

Combining inhibitory and facilitatory repetitive transcranial magnetic stimulation (rTMS) treatment improves motor function by modulating GABA in acute ischemic stroke patients

2021 ◽  
pp. 1-16
Author(s):  
Qing-Mei Chen ◽  
Fei-Rong Yao ◽  
Hai-Wei Sun ◽  
Zhi-Guo Chen ◽  
Jun Ke ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Motor Function ◽  
Magnetic Stimulation ◽  
Sham Group ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Motor Dysfunction ◽  
Gaba Level ◽  
Stroke Patients ◽  
Before And After

Background: The combination of inhibitory and facilitatory repetitive transcranial magnetic stimulation (rTMS) can improve motor function of stroke patients with undefined mechanism. It has been demonstrated that rTMS exhibits a neuro-modulatory effect by regulating the major inhibitory neurotransmitter γ-aminobutyric acid (GABA) in other diseases. Objectives: To evaluate the effect of combined inhibitory and facilitatory rTMS on GABA in the primary motor cortex (M1) for treating motor dysfunction after acute ischemic stroke. Methods: 44 ischemic stroke patients with motor dysfunction were randomly divided into two groups. The treatment group was stimulated with 10 Hz rTMS at the ipsilesional M1 and 1 Hz rTMS at the contralesional M1. The sham group received bilateral sham stimulation at the motor cortices. The GABA level in the bilateral M1 was measured by proton magnetic resonance spectroscopy (1H-MRS) at 24 hours before and after rTMS stimulation. Motor function was measured using the Fugl-Meyer Assessment (FMA). The clinical assessments were performed before and after rTMS and after 3 months. Results: The treatment group exhibited a greater improvement in motor function 24 hours after rTMS compared to the sham group. The increased improvement in motor function lasted for at least 3 months after treatment. Following 4 weeks of rTMS, the GABA level in the ipsilesional M1 of the treatment group was significantly decreased compared to the sham group. Furthermore, the change of FMA score for motor function was negatively correlated to the change of the GABA:Cr ratio. Finally, the effect of rTMS on motor function outcome was partially mediated by GABA level change in response to the treatment (27.7%). Conclusions: Combining inhibitory and facilitatory rTMS can decrease the GABA level in M1, which is correlated to the improvement of motor function. Thus, the GABA level in M1 may be a potential biomarker for treatment strategy decisions regarding rTMS neuromodulatory interventions.

Sign in / Sign up

Export Citation Format

Share Document