Comparative study of ipsilesional and contralesional repetitive transcranial magnetic stimulations for acute infarction

JOURNAL OF THE NEUROLOGICAL SCIENCES

卷:384

Article

Watanabe, Kosuke¹  Kudo, Yosuke¹  Sugawara, Eriko¹  Nakamizo, Tomoki¹  Amari, Kazumitsu²  Takahashi, Koji³  Tanaka, Osamu³  Endo, Miho⁴  Hayakawa, Yuko⁴  Johkura, Ken¹ 

[1] Yokohama Brain & Spine Ctr, Dept Neurol, Yokohama, Kanagawa, Japan

[2] Yokohama Brain & Spine Ctr, Dept Neuroendovasc Therapy, Yokohama, Kanagawa, Japan

[3] Yokohama Brain & Spine Ctr, Dept Clin Lab, Yokohama, Kanagawa, Japan

[4] Yokohama Brain & Spine Ctr, Dept Rehabil, Yokohama, Kanagawa, Japan

关键词: Repetitive transcranial magnetic stimulation;    Intermittent theta-burst stimulation;    Low-frequency stimulation;    Motor cortex;    Acute capsular infarction;   

DOI  :  10.1016/j.jns.2017.11.001

来源: Elsevier

【 摘 要 】

Background and purpose: Repetitive transcranial magnetic stimulation (rTMS) is reported to improve chronic post-stoke hemiparesis. However, application of rTMS during the acute phase of post-stroke has not fully been investigated. We investigated the safety and the efficacy of intermittent theta-burst stimulation (iTBS) of the affected motor cortex and 1-Hz stimulation of the unaffected hemisphere during the acute phase in patients with hemiparesis due to capsular infarction. Methods: Twenty one patients who met the study criteria were randomly assigned to receive, starting within 7 days after stroke onset and for a period of 10 days, iTBS of the affected motor cortex hand area (n = 8), 1-Hz stimulation of the unaffected motor cortex hand area (n = 7), or sham stimulation (n = 6). Upper limb motor function was evaluated before rTMS and 12 weeks after onset of the stroke. Evaluation was based on the Fugl-Meyer Assessment (FMA), Stroke Impairment Assessment Set (SIAS), Modified Ashworth Scale (MAS), grip strength, and motor evoked potential (MEP) amplitude in the first dorsal interosseous (FDI) muscle. Results: Both iTBS applied to the affected motor cortex hand area and 1-Hz stimulation applied to the unaffected motor cortex hand area enhanced motor recovery. In comparison to sham stimulation, iTBS increased the SIAS finger-function test score, and 1-Hz stimulation decreased the MAS wrist and finger score. Conclusions: Ipsilesional iTBS and contralesional 1-Hz stimulation applied during the acute phase of stroke have different effects: ipsilesional iTBS improves movement of the affected limb, whereas contralesional 1-Hz stimulation reduces spasticity of the affected limb.

【 授权许可】

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