Repetitive transcranial magnetic stimulation-induced corticomotor excitability and associated motor skill acquisition in chronic stroke.
OBJECTIVE
Although there is some early evidence showing the value of repetitive transcranial magnetic stimulation (rTMS) in stroke rehabilitation, the therapeutic effect of high-frequency rTMS, along with the physiology of rTMS-induced corticomotor excitability supporting motor learning in stroke, has not been established. This study investigated high-frequency rTMS-induced cortical excitability and the associated motor skill acquisition in chronic stroke patients.


METHODS
Fifteen patients with chronic hemiparetic stroke (13 men; mean age 53.5 years) practiced a complex, sequential finger motor task using their paretic fingers either after 10 Hz or sham rTMS over the contralateral primary motor cortex (M1). Both the changes in the behavior and corticomotor excitability before and after the intervention were examined by measuring the movement accuracy, the movement time, and the motor-evoked potential (MEP) amplitude. A separate repeated-measures ANOVA and correlation statistics were used to determine the main and interaction effects as well as relationship between the changes in the behavioral and corticomotor excitability.


RESULTS
High-frequency rTMS resulted in a significantly larger increase in the MEP amplitude than the sham rTMS (P<0.01), and the plastic change was positively associated with an enhanced motor performance accuracy (P<0.05).


CONCLUSIONS
High-frequency rTMS of the affected motor cortex can facilitate practice-dependent plasticity and improve the motor learning performance in chronic stroke victims.
Kim
Yun-Hee
YH
Department of Physical Therapy, Graduate School of Rehabilitation Therapy, Yonsei University, Wonju City, Kangwon-do [corrected] Republic of Korea. yunkim@smc.samsung.co.kr
You
Sung H
SH
Ko
Myoung-Hwan
MH
Park
Ji-Won
JW
Lee
Kwang Ho
KH
Jang
Sung Ho
SH
Yoo
Woo-Kyoung
WK
Hallett
Mark
M