Long-term effect of low-frequency repetitive transcranial magnetic stimulation over the unaffected posterior parietal cortex in patients with unilateral spatial neglect.
OBJECTIVE
To explore long-term effects on unilateral spatial neglect of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the unaffected posterior parietal cortex.


METHODS
Uncontrolled pilot study.


METHODS
Two chronic-phase patients with left-sided unilateral spatial neglect from cerebral infarction.


METHODS
Six rTMS sessions were undertaken for 2 weeks. Each session included 900 stimuli applied over P5 at an intensity of 95% motor thresholds and a frequency of 0.9 Hz. The Behavioural Inattention Test, either the Mini-Mental State Examination or the Revised Hasegawa Dementia Scale, Brunnstrom Recovery Stage, and Barthel Index were evaluated at 2-week intervals until 6 weeks after rTMS sessions. Single-photon emission computed tomography was performed 2 weeks before and after rTMS.


RESULTS
Behavioural Inattention Test scores improved remarkably, especially from 2 to 4 weeks after rTMS sessions. At 6 weeks, Behavioural Inattention Test scores still remained above pre-rTMS levels. Other clinical evaluations as well as single-photon emission computed tomography showed no significant change during the study.


CONCLUSIONS
In this small pilot study, low-frequency rTMS over the unaffected posterior parietal cortex decreased unilateral spatial neglect for at least 6 weeks.
Shindo
Keiichiro
K
Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan. krug1973@mail.tains.tohoku.ac.jp
Sugiyama
Ken
K
Huabao
Lu
L
Nishijima
Kazunori
K
Kondo
Takeo
T
Izumi
Shin-Ichi
S
D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000503:physiopathology; D010865:Pilot Projects; D020127:Recovery of Function; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000379:methods*