ABSTRACT
Objective : It has been reported that low frequency repetitive transcranial magnetic stimulation (rTMS) over the unaffected motor cortex improves motor function of the paretic hand in stroke patients by decreasing transcallosal function, which involves bilateral movement. However, it remains to be clarified whether low frequency rTMS deteriorates bilateral movement. In this study, we evaluated the cortico-cortical coupling and the function of bilateral movement after rTMS in stroke patients. Methods : 1 Hz rTMS was applied over the unaffected motor cortex of chronic stroke patients (10 patients, 63.5±8.6 years). Then, we evaluated motor function involving bilateral hands movement and coupling of the cortices by performing electroencephalographic coherence analysis before and after rTMS. Results : We found that rTMS improved acceleration in the paretic hand but deteriorated bilateral movement coordination. The improvement of motor function in the paretic hand lasted for a week after rTMS while the coordination of bilateral movement normalized within 30 min after rTMS. There was no change in the motor function of the intact hand after rTMS. Coordination of bilateral movement has a positive correlation with the coherence of the bilateral hemispheres and the coherence of the supplemental motor cortex and ipsilesional motor cortex. Conclusions : rTMS therapy improved motor function of the paretic hand in stroke patients. However, it temporarily deteriorated bilateral movement coordination. The supplemental motor cortex and ipsilesional motor cortex coupling might help reduce this deterioration in bilateral movement coordination by lessening the coupling between the bilateral hemispheres.
ABSTRACT
To assess the surface electromyography of neck [sternocleidomastoid, splenius capitis and trapezeius], face [masseter] and head [temporalis] muscles during brushing teeth with Miswak [a tree-twig used for cleansing the teeth] as a novel physical agent that may play a vital role in neck, face and head muscles exercise. Surface electromyography [sEMG] has been used to examine the neuromuscular activity of neck, face and head muscles under different teeth brushing circumstances of three healthy persons. EMG showed rhythmic muscular activity of sternocleidomastoid, splenius capitis, trapeze ius and continuous muscular activity of temporalis and masseter muscles of both sides from the force and movement of shoulder joint exerted by the user during brushing teeth with Miswak. Most likely brushing with Miswak would play an imperative role as a new physical agent by putting forth intermittent compression effect on neck, face and head muscles exercise. This study is also a direction for future research on utilization of Miswak as a physical agent or a physical device in rehabilitation programs in order to accomplish pericranial muscles exercise that might be advantageous for chronic neck pain, headache due to muscle contraction [tension-type headache] and torticollis