Abstract
Background: Repetitive transcranial magnetic stimulation (rTMS) can modulate cortical excitability, and may be beneficial for motor recovery after stroke. However, the neuroplasticity effects of rTMS have not been thoroughly investigated in the early stage after stroke. Objective: To comprehensively assess the effects of high- and low-frequency repetitive transcranial magnetic stimulations on motor recovery in early stroke patients, using a randomized controlled trial based on clinical, neurophysiological and functional imaging assessments. Methods: Sixty hospitalized, first-ever ischemic stroke patients (within 2 weeks after stroke) with motor deficits were randomly allocated to receive, in addition to standard physical therapy, five consecutive sessions of either: (1) High-frequency (HF) rTMS at 10 Hz over the ipsilesional primary motor cortex (M1); (2) Low-frequency (LF) rTMS at 1 Hz over the contralesional M1; (3) sham rTMS. The primary outcome measure was a motor impairment score (Upper Extremity Fugl-Meyer) evaluated at baseline, after rTMS intervention, and at 3-month follow-up. Cortical excitability and functional magnetic resonance imaging (fMRI) data were obtained within 24 h before and after rTMS intervention. Analyses of variance were conducted to compare the recovery effects among the three rTMS groups, assessed using clinical, neurophysiological and fMRI tests. Results: Motor improvement was significantly larger in the two rTMS groups than in the control group. The HF-rTMS group showed significantly increased cortical excitability and motor-evoked fMRI activation in ipsilesional motor areas, whereas the LF-rTMS group had significantly decreased cortical excitability and motor-evoked fMRI activation in contralesional motor areas. Activity in ipsilesional motor cortex significantly correlated with motor function, after intervention as well as at 3-month follow-up. Conclusion: HF- and LF-rTMS can both improve motor function by modulating motor cortical activation in the early phase of stroke.
| Original language | English |
|---|---|
| Number of pages | 1 |
| Journal | NeuroImage: Clinical |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2018 |
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Keywords
- fMRI
- Interhemispheric inhibition
- Motor recovery
- Neuroplasticity
- Stroke
- Transcranial magnetic stimulation
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Neurology
- Clinical Neurology
- Cognitive Neuroscience
Cite this
Effects of high- and low-frequency repetitive transcranial magnetic stimulation on motor recovery in early stroke patients : Evidence from a randomized controlled trial with clinical, neurophysiological and functional imaging assessments. / Du, Juan; Yang, Fang; Hu, Jianping; Hu, Jingze; Xu, Qiang; Cong, Nathan; Zhang, Qirui; Liu, Ling; Mantini, Dante; Zhang, Zhiqiang; Lu, Guangming; Liu, Xinfeng.
In: NeuroImage: Clinical, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of high- and low-frequency repetitive transcranial magnetic stimulation on motor recovery in early stroke patients
T2 - Evidence from a randomized controlled trial with clinical, neurophysiological and functional imaging assessments
AU - Du, Juan
AU - Yang, Fang
AU - Hu, Jianping
AU - Hu, Jingze
AU - Xu, Qiang
AU - Cong, Nathan
AU - Zhang, Qirui
AU - Liu, Ling
AU - Mantini, Dante
AU - Zhang, Zhiqiang
AU - Lu, Guangming
AU - Liu, Xinfeng
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Repetitive transcranial magnetic stimulation (rTMS) can modulate cortical excitability, and may be beneficial for motor recovery after stroke. However, the neuroplasticity effects of rTMS have not been thoroughly investigated in the early stage after stroke. Objective: To comprehensively assess the effects of high- and low-frequency repetitive transcranial magnetic stimulations on motor recovery in early stroke patients, using a randomized controlled trial based on clinical, neurophysiological and functional imaging assessments. Methods: Sixty hospitalized, first-ever ischemic stroke patients (within 2 weeks after stroke) with motor deficits were randomly allocated to receive, in addition to standard physical therapy, five consecutive sessions of either: (1) High-frequency (HF) rTMS at 10 Hz over the ipsilesional primary motor cortex (M1); (2) Low-frequency (LF) rTMS at 1 Hz over the contralesional M1; (3) sham rTMS. The primary outcome measure was a motor impairment score (Upper Extremity Fugl-Meyer) evaluated at baseline, after rTMS intervention, and at 3-month follow-up. Cortical excitability and functional magnetic resonance imaging (fMRI) data were obtained within 24 h before and after rTMS intervention. Analyses of variance were conducted to compare the recovery effects among the three rTMS groups, assessed using clinical, neurophysiological and fMRI tests. Results: Motor improvement was significantly larger in the two rTMS groups than in the control group. The HF-rTMS group showed significantly increased cortical excitability and motor-evoked fMRI activation in ipsilesional motor areas, whereas the LF-rTMS group had significantly decreased cortical excitability and motor-evoked fMRI activation in contralesional motor areas. Activity in ipsilesional motor cortex significantly correlated with motor function, after intervention as well as at 3-month follow-up. Conclusion: HF- and LF-rTMS can both improve motor function by modulating motor cortical activation in the early phase of stroke.
AB - Background: Repetitive transcranial magnetic stimulation (rTMS) can modulate cortical excitability, and may be beneficial for motor recovery after stroke. However, the neuroplasticity effects of rTMS have not been thoroughly investigated in the early stage after stroke. Objective: To comprehensively assess the effects of high- and low-frequency repetitive transcranial magnetic stimulations on motor recovery in early stroke patients, using a randomized controlled trial based on clinical, neurophysiological and functional imaging assessments. Methods: Sixty hospitalized, first-ever ischemic stroke patients (within 2 weeks after stroke) with motor deficits were randomly allocated to receive, in addition to standard physical therapy, five consecutive sessions of either: (1) High-frequency (HF) rTMS at 10 Hz over the ipsilesional primary motor cortex (M1); (2) Low-frequency (LF) rTMS at 1 Hz over the contralesional M1; (3) sham rTMS. The primary outcome measure was a motor impairment score (Upper Extremity Fugl-Meyer) evaluated at baseline, after rTMS intervention, and at 3-month follow-up. Cortical excitability and functional magnetic resonance imaging (fMRI) data were obtained within 24 h before and after rTMS intervention. Analyses of variance were conducted to compare the recovery effects among the three rTMS groups, assessed using clinical, neurophysiological and fMRI tests. Results: Motor improvement was significantly larger in the two rTMS groups than in the control group. The HF-rTMS group showed significantly increased cortical excitability and motor-evoked fMRI activation in ipsilesional motor areas, whereas the LF-rTMS group had significantly decreased cortical excitability and motor-evoked fMRI activation in contralesional motor areas. Activity in ipsilesional motor cortex significantly correlated with motor function, after intervention as well as at 3-month follow-up. Conclusion: HF- and LF-rTMS can both improve motor function by modulating motor cortical activation in the early phase of stroke.
KW - fMRI
KW - Interhemispheric inhibition
KW - Motor recovery
KW - Neuroplasticity
KW - Stroke
KW - Transcranial magnetic stimulation
UR - http://www.scopus.com/inward/record.url?scp=85057579352&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85057579352&partnerID=8YFLogxK
U2 - 10.1016/j.nicl.2018.101620
DO - 10.1016/j.nicl.2018.101620
M3 - Article
AN - SCOPUS:85057579352
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
SN - 2213-1582
ER -