scholarly journals The Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Functional Indices of Affected Upper Limb in Patients with Subacute Stroke

Author(s):  
F Moslemi Haghighi ◽  
A Kordi Yoosefinejad ◽  
M Razeghi ◽  
A H Shariat ◽  
Z Bagheri ◽  
...  

Background: Repetitive transcranial magnetic stimulation (rTMS) is a novel technique that may improve recovery in patients with stoke, but the role of rTMS as an applied and practical treatment modality for stroke rehabilitation has not been established yet.Objective: This study was conducted to determine the effects of a rehabilitation program (RP) in conjunction with rTMS on functional indices of the paretic upper limb in the subacute phase of stroke.Material and Methods: Twenty patients in the subacute phase of stroke were randomly assigned into two groups: The high frequency rTMS (HF-rTMS) in conjunction with RP (experimental group), and the RP group (control group). The experimental group received 10 sessions of 20 Hz rTMS on the affected primary motor cortex and the other group received 10 sessions of RP. In experimental group, RP for the paretic hand was conducted following rTMS session. Box and block test (BBT), Fugl-Meyer Motor Assessment for upper limb (FMA-UL), grip strength and pinch strength were used to assess motor function before the first session and after  the last session of treatment.Results: Significant improvement in BBT, FMA-UL, grip strength and pinch strength was observed in both groups. Improvement of BBT and grip strength was significantly greater in the experimental group rather than the control group (p<0.05). FMA-UL score and the pinch strength were greater in the experimental group, although the differences were not statistically significant. Conclusion: HF-rTMS in conjunction with RP is effective to improve the function of upper limb. It seems HF-rTMS is a novel feasible and safe technique for hemiparesis patients in the subacute phase of stroke.

2021 ◽  
Vol 15 ◽  
Author(s):  
Jiamin Li ◽  
Cen Chen ◽  
Shenyu Zhu ◽  
Xiulian Niu ◽  
Xidan Yu ◽  
...  

Objective: The goal of this study is to explore the effect of wrist-ankle acupuncture combined with 5-Hz repetitive transcranial magnetic stimulation (rTMS) on improving spastic state and motor function of children with spastic cerebral palsy by measuring electrophysiological parameters and behaviors.Methods: Twenty-five children with spastic cerebral palsy were enrolled in a single-blind and randomized controlled trial. The control group received 20 sessions of 5-Hz rTMS over the affected hemisphere with 1,000 pulses. The experimental group was given wrist-ankle acupuncture on the basis of the control group. Gross motor function measure (GMFM-66), muscle tension, and electrophysiological parameters of the two groups were assessed at baseline and after intervention.Results: After treatment, the GMFM-66 scores in the same groups were significantly improved (p &lt; 0.001). Besides, the R-value of soleus, gastrocnemius, and hamstring muscle decreased (p &lt; 0.05), and the results showed a trend of shortening MEP latency, increasing amplitude and duration (p &lt; 0.05). Compared to the controlled group, the experimental group displayed more excellent changes in the GMFM-66 scores and motor evoked potential (MEP) latency. The statistical results showed that the increase of GMFM-66 score and the shortening of MEP latency in the experimental group were greater than that in the control group (p &lt; 0.05). However, no significant differences were found in the assessment of muscle tension, amplitude, and duration of MEPs between two groups (p &gt; 0.05).Conclusion: Wrist-ankle acupuncture combined with 5-Hz rTMS is optimal to improve gross motor function and enhance the conductivity of corticospinal tract in children with cerebral palsy but cannot highlight its clinical superiority in improving spasticity.Clinical Trial Registration: [http://www.chictr.org.cn/index.aspx], identifier [chictr2000039495].


2009 ◽  
Vol 43 (4) ◽  
pp. 386-392 ◽  
Author(s):  
Dhruv Bagati ◽  
Shamshul Haque Nizamie ◽  
Ravi Prakash

Objective: Auditory hallucinations are a characteristic symptom of schizophrenia and are usually resistant to treatment. The present study was conducted to further support the findings that repetitive transcranial magnetic stimulation (rTMS) reduces auditory hallucinations, and to evaluate the effect of low-frequency rTMS on auditory hallucinations in schizophrenia. Methods: Forty schizophrenia patients were included in the study. Patients were randomized to control or experimental group. Low-frequency rTMS (1 Hz, 90% motor threshold) was applied to the left temporoparietal cortex of patients in the experimental group for 10 days following the standard guidelines as an addition to antipsychotic treatment. The control group received only antipsychotics. The changes in the psychopathology scores for the auditory hallucinations were recorded using auditory hallucination recording scale. The rater was blind to the intervention procedure. Results: A significant improvement was found in auditory hallucinations in the experimental group as compared to the control group. Conclusion: Left temporoparietal rTMS warrants further study as an intervention for auditory hallucinations. Data suggest that this intervention selectively alters neurobiological factors determining frequency of these hallucinations.


2021 ◽  
Vol 12 ◽  
Author(s):  
Wenjie Hao ◽  
Taohua Wei ◽  
Wenming Yang ◽  
Yue Yang ◽  
Ting Cheng ◽  
...  

Background: Upper limb dystonia is a frequent complication of Wilson's disease (WD). It can lead to poor quality of life and disability. Currently, no effective treatment for it exists. Therefore, we carried out a clinical trial to determine whether high frequency repetitive transcranial magnetic stimulation (rTMS) on the primary motor cortex alleviates upper limb dystonia in WD patients.Methods: This study was a single-center, double-blind, randomized clinical study, included 60 WD patients with upper limb dystonia from a research base of WD in Hefei, China. Participants were randomly divided into a treatment group (TG) and a control group (CG). The TG received rTMS at 10 Hz, while the CG received sham stimulation for 7 consecutive days. Participants were assessed at baseline, after the seventh treatment session, and at 2 and 4 weeks after the seventh treatment session. The primary outcomes included patients' objective muscle tension and stiffness as measured with the MyotonPRO device. The secondary results were scores on clinical scales assessing muscle spasm and motor symptoms, which included the Modified Ashworth Scale (MAS), Unified Wilson's Disease Rating Scale (UWDRS), Burke Fahn Marsden Scale (BFM), and the Activities of Daily Living (ADL) scale.Results: The analysis revealed that after 10 Hz rTMS, muscle tension (P &lt; 0.01) and stiffness (P &lt; 0.01) as measured by the MyotonPRO device decreased significantly in the TG compared to the CG. Moreover, clinically relevant scale scores, including the MAS (P &lt; 0.01), UWDRS (P &lt; 0.01), BFM (P &lt; 0.01), and ADL (P &lt; 0.01) were also significantly reduced.Conclusion: High-frequency rTMS over the primary motor cortex may be an effective complementary and alternative therapy to alleviating upper limb dystonia in WD patients.Clinical Trial Registration:http://www.chictr.org.cn/, identifier: ChiCTR2100046258.


Author(s):  
Yupeng Du ◽  
Li Wei ◽  
Huangwei Jiang

Abstract Objective To study the improvements and mechanism of repetitive transcranial magnetic stimulation (rTMS) on swallowing disorders after cerebral infarction. Methods A total of 60 patients with swallowing disorders were randomly assigned to receive high/low-frequency rTMS treatment, another 30 patients without rTMS treatment were included in the control group. The Kubota’s water-swallowing test, video fluoroscopic swallowing study (VFSS), and major intracranial neurotransmitters were analyzed before and after treatment. Results No significant difference was observed in the Kubota’s water-swallowing test scores, the VFSS scores, or the levels of intracranial neurotransmitters between the three groups before treatment. The Kubota’s water-swallowing test scores were significantly reduced after high-frequency rTMS treatment than in the control group; the aspiration degree was significantly increased after high-frequency rTMS treatment than in the control group; the levels of glutamate and dopamine were significantly increased after high-frequency rTMS treatment than in the control group; Moreover, the Kubota’s water-swallowing test scores were significantly reduced after high-frequency rTMS treatment than after low-frequency rTMS treatment; the levels of glutamate and dopamine were significantly increased after high-frequency rTMS treatment than after low-frequency rTMS treatment. Conclusions High-frequency rTMS was effective for swallowing disorders, which may be related to increased levels of intracranial glutamate and dopamine.


Author(s):  
Ann Ali AbdElkader ◽  
Ebtesam Mohammed Fahmy ◽  
Ayat Allah Farouk Ahmad ◽  
Amira A. Labib ◽  
Leqaa Ali El-Mekkawy ◽  
...  

Abstract Background Headache is the most common pain disorder, affecting around 66% of the global population. This study aimed to investigate the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating patients with primary chronic daily headaches (chronic tension-type headache and chronic migraine). Methods Twenty-seven patients participated in the study, divided into 2 groups: a study group (16 patients) and a control group (11 patients). Treatment consisted of 12 high-frequency (5 Hz) real rTMS sessions, delivered over the left dorsolateral prefrontal cortex (DLPFC), whereas sham rTMS was used for the control group. Results Patients of the study group, after real rTMS stimulation, showed a high statistically significant reduction of the measured headache parameters compared to the control group (P value < 0.001), and the percentage of improvement was 94.5%. No significant reduction of headache parameters, after sham rTMS stimulation, was observed in the control group (P value > 0.05) and the percentage of improvement was 7.9%. Conclusion High-frequency rTMS is effective in reducing chronic tension headaches and chronic migraines. This finding runs with the approval of the suggested role of DLPFC in pain control. This might open opinions for new treatment strategies in tension-type headache and migraine prevention.


Background: The purpose of the present study was to investigate the effectiveness of high frequency transcranial magnetic stimulation (rTMS) treatment (20 Hz) on auditory hallucinations, inner speech and working memory in schizophrenic patients. Materials and Methods: This study was a pretest-posttest experimental design with control group. The statistical population of this study consisted of all schizophrenic patients referring to the outpatient department of Imam Hossein hospital in 2019, 12 of whom were selected by available sampling based on inclusion and exclusion criteria then were assigned randomly into two groups of 6 each. High frequency transcranial magnetic stimulation (r TMS) treatment (20 Hz) was used for experimental group but the control group received no intervention during the study. The instruments were the positive and negative syndrome scale in schizophrenia, the inner speech questionnaire, and the Daneman and Carpenter working memory questionnaire before and after the intervention. The data were analyzed by descriptive statistics, and one-way covariance analysis (ANCOVA) and multivariate covariance analysis (MANCOVA) were used to analyze the data. Results: The results showed that there were significant differences between experimental and control group (p<0.005). The rate of auditory hallucinations and inner speech significantly decreased in comparison with pretest and control group, but the rate of active memory increased. Conclusion: Repetitive transcranial magnetic stimulation (r TMS) treatment (20 Hz) significantly reduced auditory hallucinations, inner speech and improved active memory.


Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 491
Author(s):  
Donghyun Yi ◽  
Hwanyong Lim ◽  
Jongeun Yim

Background and Objectives: The purpose of this study was to investigate the effects of microcurrent stimulation on pain, shoulder function, and grip strength in patients with rotator cuff repair. Materials and Methods: This randomized single-blind controlled trial was conducted on inpatients of the rehabilitation department, and included 28 patients who underwent rotator cuff repair. Participants were randomly assigned to the experimental group (n = 14), treated with microcurrent stimulation, and the control group (n = 14), treated with false microcurrent stimulation. The microcurrent stimulation administered to the experimental group underwent general physical therapy and microcurrent stimulation three times a week for 4 weeks. Results: Changes in pain, range of motion in shoulder, simple shoulder test, and grip strength were assessed before and after the intervention. Both groups showed a significant decrease in pain and shoulder function (t = 27.412, 22.079, 19.079, and 18.561; p < 0.001), and grip strength showed a significant increase (t = −8.251 and −9.946; p < 0.001). The experimental group that underwent microcurrent stimulation exhibited a significant effect on pain, shoulder function, and grip strength compared with the control group that underwent false microcurrent stimulation (t = −2.17, −2.22, and 2.213; p = 0.039, 0.035, and 0.036). Conclusions: This study confirmed that microcurrent stimulation is effective for the treatment of rotator cuff repair patients.


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