Open AccessEffectiveness of repetitive transcranial magnetic stimulation (rTMS) after acute stroke: A one‐year longitudinal randomized trial
Author(s) -
Guan YuZhou,
Li Jing,
Zhang XueWei,
Wu Shuang,
Du Hua,
Cui LiYing,
Zhang WeiHong
Publication year - 2017
Publication title -
cns neuroscience and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 69
eISSN - 1755-5949
pISSN - 1755-5930
DOI - 10.1111/cns.12762
Subject(s) - transcranial magnetic stimulation , medicine , randomized controlled trial , stroke (engine) , barthel index , upper limb , physical therapy , physical medicine and rehabilitation , anesthesia , rehabilitation , stimulation , mechanical engineering , engineering
Summary Aims To evaluate the effectiveness of repetitive transcranial magnetic stimulation ( rTMS ) on motor recovery after stroke using a prospective, double‐blind, randomized, sham‐controlled study. Methods Patients with unilateral subcortical infarction in the middle cerebral artery territory within 1 week after onset were enrolled. The patients were randomly divided into an rTMS treatment group and a sham group. We performed high‐frequency rTMS or sham rTMS on the two groups. Motor functional scores were assessed pre‐ and post‐ rTMS /sham rTMS and at 1 month, 3 months, 6 months, and 1 year after stroke onset. The scores included the National Institutes of Health Stroke Scale ( NIHSS ), Barthel Index ( BI ), Fugl‐Meyer Assessment Upper Limb/Lower Limb ( FMA ‐ UL / LL ), modified Rank Score ( mRS ), and the resting motor threshold ( RMT ) of the hemiplegic limb. Results At baseline, no significant differences were found between the two groups for motor functional scores. On the second day after rTMS treatment, score improvements of the NIHSS , BI , FMA ‐ UL in the real treatment group were more significant than those in the sham group. In addition, similar results were obtained at 1 month. However, at 3 months, 6 months, and 1 year after onset, no significant differences in improvement were observed between the two groups, except for the FMA ‐ UL score improvement. Conclusion rTMS facilitates motor recovery of acute stroke patients, and the effect can last to 1 month, except the function improvement on upper extremities could last for 1 year. A single course of rTMS in the acute stage may induce the improvement of upper extremities function lasted for 1 year.