scholarly journals Central Post-Stroke Pain: An Integrative Review of Somatotopic Damage, Clinical Symptoms, and Neurophysiological Measures

2021 ◽  
Vol 12 ◽  
Author(s):  
Daniel Fernando Arias Betancur ◽  
Maria da Graça Lopes Tarragó ◽  
Iraci Lucena da Silva Torres ◽  
Felipe Fregni ◽  
Wolnei Caumo
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Methodological Quality ◽  
Magnetic Stimulation ◽  
Clinical Symptoms ◽  
Cortical Excitability ◽  
Short Interval ◽  
Control Group ◽  
Cerebral Stroke ◽  
Post Stroke

Introduction: The physiopathology of central post-stroke pain (CPSP) is poorly understood, which may contribute to the limitations of diagnostic and therapeutic advancements. Thus, the current systematic review was conducted to examine, from an integrated perspective, the cortical neurophysiological changes observed via transcranial magnetic stimulation (TMS), focusing on the structural damage, and clinical symptoms in patients with CPSP.Methods: The literature review included the databases EMBASE, PubMed, and ScienceDirect using the following search terms by MeSH or Entree descriptors: [(“Cerebral Stroke”) AND (“Pain” OR “Transcranial Magnetic Stimulation”) AND (“Transcranial Magnetic Stimulation”)] (through September 29, 2020). A total of 297 articles related to CPSP were identified. Of these, only four quantitatively recorded cortical measurements.Results: We found four studies with different methodologies and results of the TMS measures. According to the National Institutes of Health (NIH) guidelines, two studies had low methodological quality and the other two studies had satisfactory methodological quality. The four studies compared the motor threshold (MT) of the stroke-affected hemisphere with the unaffected hemisphere or with healthy controls. Two studies assessed other cortical excitability measures, such as cortical silent period (CSP), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF). The main limitations in the interpretation of the results were the heterogeneity in parameter measurements, unknown cortical excitability measures as potential prognostic markers, the lack of a control group without pain, and the absence of consistent and validated diagnosis criteria.Conclusion: Despite the limited number of studies that prevented us from conducting a meta-analysis, the dataset of this systematic review provides evidence to improve the understanding of CPSP physiopathology. Additionally, these studies support the construction of a framework for diagnosis and will help improve the methodological quality of future research in somatosensory sequelae following stroke. Furthermore, they offer a way to integrate dysfunctional neuroplasticity markers that are indirectly assessed by neurophysiological measures with their correlated clinical symptoms.

scholarly journals Application of rhythmic transcranial magnetic stimulation with low-intensive running pulsed magnetic field in the rehabilitation of patients with post-stroke cognitive impairment syndrome

2020 ◽  
Vol 12 (2) ◽  
pp. 51-62
Author(s):  
Alexey Е. Tereshin ◽  
Vera V. Kiryanova ◽  
Dmitry A. Reshetnik ◽  
Marina V. Karyagina ◽  
Elena K. Savelyeva ◽  
...  
Keyword(s):  
Magnetic Field ◽  
Cognitive Impairment ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Modulation Frequency ◽  
Recovery Period ◽  
Pulsed Magnetic Field ◽  
Control Group ◽  
Early Recovery ◽  
Post Stroke

The purpose of the investigation was to study the nootropic effects of rhythmic transcranial magnetic stimulation (rTMS) using low-intensity magnetic field with the induction rate of 45 mT, base frequency of 50 Hz, modulation frequency of 10 Hz in combination with standard medical and psychological therapy in the rehabilitation of patients with post-stroke cognitive impairment (PSCI). Materials and methods. The rehabilitation outcomes in 98 patients with PSCI syndrome were studied. The patients were subdivided into 2 groups: 53 patients of the control group were treated with the standard nootropic medications and neuropsychological procedures; 45 patients of the main group were additionally treated with rTMS by the low-intensive running pulsed magnetic field of 10 Hz modulation frequency. The dynamics of the score increase according to Rivermid, Karnovsky, Roshina, MMSE, mRS, HDRS, SF-36 scales were analyzed. Conclusion. Application of rTMS with low-intensive running pulsed magnetic field of 10 Hz modulation frequency in combination with a standard program of cognitive rehabilitation contributes to a significant improvement in the recovery of mental calculation function in ischemic stroke patients, as well as normalization in mood swings in the patients who had suffered a hemorrhagic stroke and post-stroke depression. This variant of rTMS can be safely used in patients with PSCI syndrome in the early recovery period, 3 weeks after the onset of stroke.

scholarly journals Transcranial Magnetic Stimulation as a Diagnostic and Therapeutic Tool in Various Types of Dementia

2021 ◽  
Vol 10 (13) ◽  
pp. 2875
Author(s):  
Jakub Antczak ◽  
Gabriela Rusin ◽  
Agnieszka Słowik
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Brain Plasticity ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Neurological Diseases ◽  
Short Interval ◽  
Cholinergic Neurons ◽  
Cortical Inhibition ◽  
Therapeutic Tool

Dementia is recognized as a healthcare and social burden and remains challenging in terms of proper diagnosis and treatment. Transcranial magnetic stimulation (TMS) is a diagnostic and therapeutic tool in various neurological diseases that noninvasively investigates cortical excitability and connectivity and can induce brain plasticity. This article reviews findings on TMS in common dementia types as well as therapeutic results. Alzheimer’s disease (AD) is characterized by increased cortical excitability and reduced cortical inhibition, especially as mediated by cholinergic neurons and as documented by impairment of short latency inhibition (SAI). In vascular dementia, excitability is also increased. SAI may have various outcomes, which probably reflects its frequent overlap with AD. Dementia with Lewy bodies (DLB) is associated with SAI decrease. Motor cortical excitability is usually normal, reflecting the lack of corticospinal tract involvement. DLB and other dementia types are also characterized by impairment of short interval intracortical inhibition. In frontotemporal dementia, cortical excitability is increased, but SAI is normal. Repetitive transcranial magnetic stimulation has the potential to improve cognitive function. It has been extensively studied in AD, showing promising results after multisite stimulation. TMS with electroencephalography recording opens new possibilities for improving diagnostic accuracy; however, more studies are needed to support the existing data.

scholarly journals Repetitive transcranial magnetic stimulation in combination with neuromuscular electrical stimulation for treatment of post-stroke dysphagia

2018 ◽  
Vol 47 (2) ◽  
pp. 662-672 ◽  
Author(s):  
Chengliang Zhang ◽  
Xiuqin Zheng ◽  
Rulan Lu ◽  
Wenwei Yun ◽  
Huifang Yun ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Neuromuscular Electrical Stimulation ◽  
Motor Evoked Potential ◽  
Swallowing Function ◽  
Post Stroke ◽  
Representative Area

Objective This study was performed to determine whether repetitive transcranial magnetic stimulation (rTMS) combined with neuromuscular electrical stimulation (NMES) effectively ameliorates dysphagia and how rTMS protocols (bilateral vs. unilateral) combined with NMES can be optimized. Methods Sixty-four patients were randomly divided into four groups using a random distribution table: the sham rTMS plus NMES (Sham-rTMS/NMES), ipsilesional 10-Hz rTMS plus NMES (Ipsi-rTMS/NMES), contralesional 1-Hz rTMS plus NMES (Contra-rTMS/NMES), and bilateral rTMS plus NMES (Bi-rTMS/NMES) groups. Cortical excitability as measured by the amplitude of the motor evoked potential at the mylohyoid muscle cortical representative area, swallowing function as measured by the Standardized Swallowing Assessment, and the degree of dysphagia were evaluated at baseline, after the stimulation course, and at the 1-month follow-up. Results Bi-rTMS/NMES produced higher cortical excitability and better swallowing function recovery. Compared with NMES alone, unilateral rTMS plus NMES had additional effects on cortical excitability and rehabilitation of dysphagia, but there were no differences between the Contra-rTMS/NMES and Ipsi-rTMS/NMES groups. No adverse events occurred. Conclusion The combination of rTMS with NMES was superior to NMES alone in improving the recovery of post-stroke dysphagia, and the combination of bilateral rTMS with NMES was more effective than unilateral rTMS combined with NMES.

SLEEP DISORDERS AND THEIR COMPLEX REHABILITATION USING TRANSCRANIAL MAGNETIC STIMULATION IN POST-STROKE REHABILITATION: STUDY DESIGN

2021 ◽  
pp. 59-63
Author(s):  
Akhmadeeva L.R. ◽  
Valiev V.S. ◽  
Naprienko M.V.
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Sleep Disorders ◽  
Stroke Rehabilitation ◽  
Magnetic Stimulation ◽  
Recovery Period ◽  
Practical Importance ◽  
Clinical Effectiveness ◽  
Cerebral Stroke ◽  
Early Recovery ◽  
Post Stroke

In the Republic of Bashkortostan, a new original study of sleep-in patients in the recovery period of cerebral stroke is planned. One of the goals will be to improve the algorithms of sleep disorders management in complex post-stroke rehabilitation using rhythmic transcranial magnetic stimulation (rTMS). In this paper, we present the design of this study using modern instrumental and clinical technologies for the diagnosis of sleep disorders and rehabilitation. The work will be of practical importance in rehabilitation medicine and neurology for improving the quality of life of patients who have suffered acute cerebral circulatory disorders. We plan to study sleep disorders in patients in the early recovery period of stroke using clinical and polysomnographic techniques, to evaluate the safety and clinical effectiveness of rTMS in the studied patients with sleep disorders, to study the duration of the effects of rTMS on sleep normalization. The successful completion of the study will help to add to algorithms for correcting sleep disorders in post-stroke rehabilitation using transcranial magnetic stimulation.

scholarly journals Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor

2021 ◽  
Vol 11 ◽  
Author(s):  
Iuri Santana Neville ◽  
Alexandra Gomes dos Santos ◽  
Cesar Cimonari Almeida ◽  
Cintya Yukie Hayashi ◽  
Davi Jorge Fontoura Solla ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Short Interval ◽  
Motor Evoked Potential ◽  
Biological Behavior ◽  
Navigated Transcranial Magnetic Stimulation ◽  
Resting Motor Threshold

Background: This prospective study aimed to evaluate the cortical excitability (CE) of patients with brain tumors surrounding or directly involving the corticospinal tract (CST) using navigated transcranial magnetic stimulation (nTMS).Methods: We recruited 40 patients with a single brain tumor surrounding or directly involving the CST as well as 82 age- and sex-matched healthy controls. The patients underwent standard nTMS and CE evaluations. Single and paired pulses were applied to the primary motor area (M1) of both affected and unaffected cerebral hemispheres 1 week before surgery. The CE parameters included resting motor threshold (RMT), motor evoked potential (MEP) ratio for 140 and 120% stimulus (MEP 140/120 ratio), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF). Motor outcome was evaluated on hospital discharge and on 30-day and 90-day postoperative follow-up.Results: In the affected hemispheres of patients, SICI and ICF were significantly higher than in the unaffected hemispheres (p=0.002 and p=0.009, respectively). The 140/120 MEP ratio of patients' unaffected hemispheres was lower than that in controls (p=0.001). Patients with glioblastomas (GBM) had a higher interhemispheric RMT ratio than patients with grade II and III gliomas (p = 0.018). A weak correlation was observed among the RMT ratio and the preoperative motor score (R2 = 0.118, p = 0.017) and the 90-day follow-up (R2 = 0.227, p = 0.016).Conclusion: Using preoperative nTMS, we found that brain hemispheres affected by tumors had abnormal CE and that patients with GBM had a distinct pattern of CE. These findings suggest that tumor biological behavior might play a role in CE changes.

Sign in / Sign up

Export Citation Format

Share Document