Transcranial magnetic stimulation can improve upper limb function after a stroke / 中华物理医学与康复杂志

ABSTRACT

Objective To explore any changes in the patterns of cortical activation after repetitive transcra-nial magnetic stimulation ( rTMS) using functional near-infrared spectroscopy when rTMS is used to treat paralyzed upper limbs. Methods Thirty hemiplegic stroke survivors were randomly divided into a treatment group and a con-trol group, each of 15. Those in the treatment group received 1 Hz rTMS on the M1 area of the unaffected hemisphere for 21 days, while the control group was given sham stimulation. The Fugl-Meyer motor assessment ( FMA-UE) was used to assess the paralyzed upper limbs before the treatment and after 7, 14 and 21 days of treatment. Oxy-hemoglo-bin ( HbO2 ) levels were measured in the premotor cortex, the supplementary motor area and the sensorimotor areas ( SMCs) of the affected and unaffected hemispheres before and after the treatment using the functional near-infrared spectroscopy. Results Before the treatment there was no significant difference between the two groups in their aver-age FMA-UE scores. The average FMA-UE scores of both groups increased significantly after 14 and 21 days of treat-ment, with the average scores at 21 days significantly better than after 14 days for both groups. But after 14 and 21 days the treatment group's average score was significantly better than that of the control group. The average HbO2 level in the SMC area of the unaffected hemisphere in the treatment group had decreased significantly after 21 days of treat-ment, and it was then significantly lower than the same level in the control group. Conclusion Twenty-one days of rTMS of the unaffected hemisphere can decrease cortical activation in the unaffected SMC area and promote the recov-ery of upper limb function.