title: Repetitive transcranial magnetic stimulation of the unaffected hemisphere in a patient who was forced to use the affected hand.
abstract: We present a case report of a 56-yr-old chronic stroke patient with right hemiparesis who was treated with repetitive transcranial magnetic stimulation (rTMS) therapy. Before stroke, the patient had suffered an accident that led to paralysis and contracture of the left upper limb, and, subsequently, he was forced to use only his right upper limb for routine activities, despite right hemiparesis. We performed subthreshold rTMS (1 Hz, 25 mins) and sham stimulation of the contralesional primary motor cortex (M1) at different times. Immediately after rTMS, the patient was able to write characters with increased speed and accuracy, and this effect continued for more than 7 days; however, this was not the case after sham stimulation. Moreover, the writing practice after rTMS improved the patient's pinch force.
authors.affiliation: Department of Rehabilitation Medicine, Hospital of Hokkaido University, Sapporo, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Takeuchi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Toshima
authors.forename: Takayo
authors.initials: T
authors.lastname: Chuma
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Katsunori
authors.initials: K
authors.lastname: Ikoma
mesh_terms: D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation