The effect of repetitive transcranial magnetic stimulation on upper extremity motor function in stroke patients: A meta-analytical review

Background and Objectives: Repetitive transcranial magnetic stimulation (rTMS) is being widely used for treating upper extremity paresis after stroke, however, evidence of applying high-frequency rTMS (HF-rTMS) on the ipsilesional hemisphere for upper extremity motor recovery remains limited. This systematic review aimed to investigate the effect of high-frequency repetitive transcranial magnetic stimulation for upper extremity motor function recovery after a first-time ischaemic stroke. Materials and Methods: This systematic review was prepared according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A comprehensive literature search was performed to identify all studies published before 12 February 2021. The search was performed on the following databases: PubMed, Ovid, The Cochrane Library. Results: A total of 6440 studies were found in the databases and four trials were included in the review. Three of the studies were randomized control trials (RCT), and one was a pseudo-RCT. Three of the studies showed good methodological quality and one study was rated as excellent. Fugl-Meyer Assessment (FMA) was performed in three out of four studies and the score significantly increased in the HF-rTMS treatment group compared with sham stimulation in all trials. Other measures used in the studies were handgrip strength, shoulder abduction, Motricity Index, Wolf Motor Function Test (WMFT), and Box and Block, although these tests did not show unanimous results. Overall, all four studies conveyed significantly better results in at least one test that was performed for hand motor function evaluation in a 10 Hz stimulation group while none of the tests showed any advantage for sham stimulation groups. Two studies reported headache as an adverse event (six patients in total). Conclusion: The overall results showed that HF-rTMS may increase impaired upper extremity motor function better than sham stimulation in stroke patients.

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Effects of Neuromuscular Electrical Stimulation Combined with Repetitive Transcranial Magnetic Stimulation on Upper Limb Motor Function Rehabilitation in Stroke Patients with Hemiplegia

Computational and Mathematical Methods in Medicine ◽

10.1155/2022/9455428 ◽

2022 ◽

Vol 2022 ◽

pp. 1-7

Author(s):

Junqiu Du ◽

Shouyong Wang ◽

Yun Cheng ◽

Jiang Xu ◽

Xuejing Li ◽

...

Keyword(s):

Electrical Stimulation ◽

Transcranial Magnetic Stimulation ◽

Upper Extremity ◽

Motor Function ◽

Upper Limb ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Motor Nerve ◽

Neuromuscular Electrical Stimulation ◽

Stroke Patients

Objective. To investigate the effect of neuromuscular electrical stimulation (NMES) combined with repetitive transcranial magnetic stimulation (rTMS) on upper limb motor dysfunction in stroke patients with hemiplegia. Methods. A total of 240 stroke patients with hemiplegia who met the inclusion criteria were selected and randomly divided into 4 groups (60 cases in each group): control group, NMES group, rTMS group, and NMES + rTMS group. Before treatment and 4 weeks after treatment, we evaluated and compared the results including Fugl-Meyer assessment of upper extremity (FMA-UE) motor function, modified Barthel index (MBI), modified Ashworth scale (MAS), and motor nerve electrophysiological results among the 4 groups. Results. Before treatment, there was no significant difference in the scores of FMA-UE, MBI, MAS, and motor nerve electrophysiological indexes among the four groups, with comparability. Compared with those before treatment, the scores of the four groups were significantly increased and improved after treatment. And the score of the NMES + rTMS group was notably higher than those in the other three groups. Conclusion. NMES combined with rTMS can conspicuously improve the upper extremity motor function and activities of daily life of stroke patients with hemiplegia, which is worthy of clinical application and promotion.

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Effect of Repetitive Transcranial Magnetic Stimulation Combined with Exercise Therapy on the Motor Function in Stroke Patients with Hemiplegia

Rehabilitation Medicine ◽

10.3724/sp.j.1329.2020.03013 ◽

2020 ◽

Vol 30 (3) ◽

pp. 235-239

Author(s):

娃妮周 ◽

磊张 ◽

润东李 ◽

开全徐 ◽

成吉吴

Keyword(s):

Transcranial Magnetic Stimulation ◽

Motor Function ◽

Exercise Therapy ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Stroke Patients

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Effects of Excitatory Repetitive Transcranial Magnetic Stimulation of the P3 Point in Chronic Stroke Patients – Case Reports

10.20944/preprints201803.0018.v2 ◽

2018 ◽

Author(s):

Ronaldo Luis da Silva ◽

Angela Maria Costa de Souza ◽

Francielly Ferreira Santos ◽

Sueli Toshie Inoue ◽

Johanne Higgins ◽

...

Keyword(s):

Transcranial Magnetic Stimulation ◽

Motor Function ◽

Lower Limb ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Case Reports ◽

Sensory Function ◽

Stroke Patients ◽

Chronic Patients ◽

Stimulation Of

Objective: to evaluate the effects of excitatory repetitive transcranial magnetic stimulation (rTMS) of the international 10-20 system P3 point (intraparietal sulcus region) in chronic patients with a frontal lesion and parietal sparing due to stroke on the impaired upper (UL) and lower limb (LL) as measured by Fugl-Meyer Assessment (FMA). Methods: three patients (C1: 49.83/2.75, C2: 53.17/3.83, C3: 63.33/3.08 years-old at stroke/ years post-stroke, respectively) received two weeks (five days/ week) of rTMS at 10 Hz of P3. A patient was treated in similar conditions with a sham coil (S1: 56.58/4.33). No complimentary therapy was delivered during the study. Patients were evaluated before, after- and two months post-treatment (A1, A2 and A3, respectively). Results: we found increased scores for LL in motor function subsection for C1 and C3 and in sensory function for C2 by A2 that remained at A3. We also found an increased score for UL motor function for C2 and C3, but the score decreased by A3 for C2. C3 score for UL range of motion increased by A3 compared to A1 and A2. Conclusion: In a variable way, P3 excitatory rTMS increased FMA scores in different upper and lower limb subsections of our three treated patients.

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