Inhibition of the unaffected motor cortex by 1 Hz repetitive transcranical magnetic stimulation enhances motor performance and training effect of the paretic hand in patients with chronic stroke.
OBJECTIVE
Recent reports demonstrated that low-frequency repetitive transcranial magnetic stimulation (rTMS) over the unaffected hemisphere improved the affected hand function in chronic stroke patients. We investigated whether 1 Hz rTMS improved the motor learning of the affected hand in patients after stroke.


METHODS
A double-blind study.


METHODS
Twenty patients with chronic subcortical stroke.


METHODS
The patients were randomly assigned to receive either a sub-threshold rTMS over the unaffected hemisphere (1 Hz, 25 minutes) or sham stimulation, and all patients performed a pinching task after stimulation. We evaluated the motor function of the affected hand and the excitatory and inhibitory function of the affected motor cortex by transcranial magnetic stimulation.


RESULTS
Compared with sham stimulation, rTMS induced an increase in the excitability of the affected motor cortex(p < 0.001) and an improvement in acceleration of the affected hand (p = 0.006). Moreover, the effect of motor training on pinch force was enhanced by rTMS (p < 0.001). These improvement in the motor function lasted for one week after rTMS and motor training (p < 0.001).


CONCLUSIONS
rTMS improved the motor learning of the affected hand in patients after stroke; thus, it can apply as anew rehabilitation strategy for patients after stroke.
Takeuchi
Naoyuki
N
Department of Rehabilitation Medicine , Hospital of Hokkaido University, Sapporo, Japan. naoyuki@med.hokudai.ac.jp
Tada
Takeo
T
Toshima
Masahiko
M
Chuma
Takayo
T
Matsuo
Yuichiro
Y
Ikoma
Katsunori
K
D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D019054:Evoked Potentials, Motor / Q000502:physiology; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009044:Motor Cortex / Q000502:physiology*; D009473:Neuronal Plasticity / Q000502:physiology; D010291:Paresis / Q000503:physiopathology* / Q000534:rehabilitation; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation