scholarly journals Cerebellar Theta Burst Stimulation on Walking Function in Stroke Patients: A Randomized Clinical Trial

2021 ◽  
Vol 15 ◽  
Author(s):  
Yun-Juan Xie ◽  
Qing-Chuan Wei ◽  
Yi Chen ◽  
Ling-Yi Liao ◽  
Bao-Jin Li ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Lower Extremity ◽  
Significant Interaction ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Stroke Patients ◽  
Significant Difference ◽  
Walking Performance ◽  
Theta Burst ◽  
Walking Time

Objectives: The objective of this study was to explore the efficacy of cerebellar intermittent theta burst stimulation (iTBS) on the walking function of stroke patients.Methods: Stroke patients with walking dysfunction aged 25–80 years who had suffered their first unilateral stroke were included. A total of 36 patients [mean (SD) age, 53 (7.93) years; 10 women (28%)] were enrolled in the study. All participants received the same conventional physical therapy, including transfer, balance, and ambulation training, during admission for 50 min per day during 2 weeks (10 sessions). Every session was preceded by 3 min procedure of cerebellar iTBS applyed over the contralesional cerebellum in the intervention group or by a similar sham iTBS in control group. The groups were formed randomly and the baseline characteristics showed no significant difference. The primary outcome measure was Fugl–Meyer Assessment–Lower Extremity scores. Secondary outcomes included walking performance and corticospinal excitability. Measures were performed before the intervention beginning (T0), after the first (T1) and the second (T2) weeks.Results: The Fugl–Meyer Assessment for lower extremity scores slightly improved with time in both groups with no significant difference between the groups and over the time. The walking performance significantly improved with time and between group. Two-way mixed measures ANOVA showed that there was significant interaction between time and group in comfortable walking time (F2,68 = 6.5242, P = 0.0080, η2partial = 0.276, ε = 0.641), between-group comparisons revealed significant differences at T1 (P = 0.0072) and T2 (P = 0.0133). The statistical analysis of maximum walking time showed that there was significant interaction between time and groups (F2,68 = 5.4354, P = 0.0115, η2partial = 0.198, ε = 0.734). Compared with T0, the differences of maximum walking time between the two groups at T1 (P = 0.0227) and T2 (P = 0.0127) were statistically significant. However, both the Timed up and go test and functional ambulation category scale did not yield significant differences between groups (P > 0.05).Conclusion: Our results revealed that applying iTBS over the contralesional cerebellum paired with physical therapy could improve walking performance in patients after stroke, implying that cerebellar iTBS intervention may be a noninvasive strategy to promote walking function in these patients. This study was registered at ChiCTR, number ChiCTR1900026450.

scholarly journals Impact of Somatosensory Training on Neural and Functional Recovery of Lower Extremity in Patients with Chronic Stroke: A Single Blind Controlled Randomized Trial

2021 ◽  
Vol 18 (2) ◽  
pp. 583
Author(s):  
Reem M. Alwhaibi ◽  
Noha F. Mahmoud ◽  
Mye A. Basheer ◽  
Hoda M. Zakaria ◽  
Mahmoud Y. Elzanaty ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Lower Extremity ◽  
Functional Recovery ◽  
Intervention Group ◽  
Chronic Stroke ◽  
Post Treatment ◽  
Control Group ◽  
Stroke Patients ◽  
Significant Difference ◽  
Group Post

Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to community reintegration. An adequate training program is required to improve neural and functional performance of the affected LE in chronic stroke patients. The current study aimed to evaluate the effect of somatosensory rehabilitation on neural and functional recovery of LE in stroke patients. Thirty male and female patients were recruited and randomized to equal groups: control group (GI) and intervention group (GII). All patients were matched for age, duration of stroke, and degree of motor impairment of the affected LE. Both groups received standard program of physical therapy in addition to somatosensory rehabilitation for GII. The duration of treatment for both groups was eight consecutive weeks. Outcome measures used were Functional Independent Measure (FIM) and Quantitative Electroencephalography (QEEG), obtained pre- and post-treatment. A significant improvement was found in the FIM scores of the intervention group (GII), as compared to the control group (GI) (p < 0.001). Additionally, QEEG scores improved within the intervention group post-treatment. QEEG scores did not improve within the control group post-treatment, except for “Cz-AR”, compared to pretreatment, with no significant difference between groups. Adding somatosensory training to standard physical therapy program results in better improvement of neuromuscular control of LE function in chronic stroke patients.

scholarly journals Theta burst stimulation for the acute treatment of major depressive disorder: A systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeffrey D. Voigt ◽  
Andrew F. Leuchter ◽  
Linda L. Carpenter
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
High Frequency Stimulation ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Major Depressive ◽  
Significant Difference ◽  
Theta Burst

AbstractPatients with major depressive disorder (MDD) may be refractory to or have contraindications that preclude treatment with antidepressant pharmacotherapies. Alternative therapies such as repetitive transcranial magnetic stimulation (rTMS) continue to evolve, and include theta burst stimulation (TBS), which has advantages over conventional rTMS. The aim of this study was to identify and meta-analyze efficacy data from all randomized controlled trials (RCTs) investigating TBS as a treatment for MDD. Published reports of RCTs (January 1, 2010 to October 23, 2020) were identified via systematic searches in computerized databases, followed by review of individual reports for inclusion. Inclusion criteria included primary diagnosis of MDD ≥ 1 week duration of therapy with ≥10 sessions, and treatment with any form of TBS. The Cochrane GRADE methodology and PRISMA criteria were used for evaluation of individual trials. Data from ten RCTs were included, representing 667 patients. Of these, 8 RCTs compared TBS to sham treatment and one compared TBS to standard rTMS (i.e., high frequency stimulation over left dorsolateral prefrontal cortex [HFL]). Quality of evidence assessment yielded high confidence in the finding of TBS being superior to sham on response measured by the Hamilton Depression Rating Scale (HRSD) (RR = 2.4; 95% CI: 1.27 to 4.55; P = 0.007; I2 = 40%). Comparison of HRSD response rates for TBS versus rTMS produced no statistically significant difference (RR = 1.02; 95% CI: 0.85 to 1.23; P = 0.80; I2 = 0%). The incidence of adverse events between TBS and rTMS was not statistically different. The findings of a positive effect of TBS vs. sham, and noninferiority of TBS vs. standard HFL rTMS support the continued development of TBS to treat depression.

Intermittent theta burst stimulation over ipsilesional primary motor cortex of subacute ischemic stroke patients: A pilot study

2013 ◽  
Vol 6 (2) ◽  
pp. 166-174 ◽  
Author(s):  
Ya-Fang Hsu ◽  
Ying-Zu Huang ◽  
Yung-Yang Lin ◽  
Chih-Wei Tang ◽  
Kwong-Kum Liao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Pilot Study ◽  
Motor Cortex ◽  
Primary Motor Cortex ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Stroke Patients ◽  
Theta Burst

scholarly journals Effects of low-frequency repetitive transcranial magnetic stimulation combined with cerebellar continuous theta burst stimulation on spasticity and limb dyskinesia in patients with stroke

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dawei Li ◽  
Aixia Cheng ◽  
Zhiyou Zhang ◽  
Yuqian Sun ◽  
Yingchun Liu
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Stroke Patients ◽  
Muscle Spasticity ◽  
Theta Burst ◽  
Continuous Theta Burst Stimulation

Abstract Background Repetitive transcranial magnetic stimulation (rTMS) has been reported to treat muscle spasticity in post-stroke patients. The purpose of this study was to explore whether combined low-frequency rTMS (LF-rTMS) and cerebellar continuous theta burst stimulation (cTBS) could provide better relief than different modalities alone for muscle spasticity and limb dyskinesia in stroke patients. Methods This study recruited ninety stroke patients with hemiplegia, who were divided into LF-rTMS+cTBS group (n=30), LF-rTMS group (n=30) and cTBS group (three pulse bursts at 50 Hz, n=30). The LF-rTMS group received 1 Hz rTMS stimulation of the motor cortical (M1) region on the unaffected side of the brain, the cTBS group received cTBS stimulation to the cerebellar region, and the LF-rTMS+cTBS group received 2 stimuli as described above. Each group received 4 weeks of stimulation followed by rehabilitation. Muscle spasticity, motor function of limb and activity of daily living (ADL) were evaluated by modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI) scores, respectively. Results The MAS score was markedly decreased, FMA and MBI scores were markedly increased in the three groups after therapy than before therapy. In addition, after therapy, LF-rTMS+cTBS group showed lower MAS score, higher FMA and MBI scores than the LF-rTMS group and cTBS group. Conclusion Muscle spasticity and limb dyskinesia of the three groups are all significantly improved after therapy. Combined LF-rTMS and cTBS treatment is more effective in improving muscle spasticity and limb dyskinesia of patients after stroke than LF-rTMS and cTBS treatment alone.

scholarly journals Facilitation of Auditory Comprehension After Theta Burst Stimulation of Wernicke's Area in Stroke Patients: A Pilot Study

2020 ◽  
Vol 10 ◽  
Author(s):  
Viviana Versace ◽  
Kerstin Schwenker ◽  
Patrick B. Langthaler ◽  
Stefan Golaszewski ◽  
Luca Sebastianelli ◽  
...  
Keyword(s):  
Pilot Study ◽  
Auditory Comprehension ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Stroke Patients ◽  
Wernicke’S Area ◽  
Theta Burst ◽  
Stimulation Of

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).

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