title: Effect of low-frequency rTMS on motor neuron excitability after stroke.
abstract: OBJECTIVE
  The purpose of this study was to test the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the non-lesional hemisphere on motor neuron excitability of the paretic upper limb in post-stroke patients by electrophysiological examination.
  
  
  METHODS
  Thirteen post-stroke patients with spastic upper limb hemiparesis were studied (age, 57.5 ± 11.1 years; time after stroke, 55.2 ± 51.4 months). Low-frequency rTMS of 1 Hz was applied for 20 min to the motor cortex of the non-lesional hemisphere. The M-response amplitude and F-wave parameters were recorded in the abductor pollicis brevis muscle following stimulation of the median nerve in both the affected and unaffected upper limbs. The F-wave frequency, F-max/M ratio (ratio of maximum F-wave amplitude to M-response amplitude), and F-mean/M ratio (the ratio of mean F-wave amplitude to the M-response amplitude) were measured before and after the 20-min rTMS, analyzed for both limbs.
  
  
  RESULTS
  Application of low-frequency rTMS did not result in significant changes in the frequency of F-wave and F-max/M ratio in both upper limbs, but significantly decreased F-mean/M ratio in the affected upper limb (P < 0.005), but not in the unaffected limb.
  
  
  CONCLUSIONS
  Low-frequency rTMS applied to the non-lesional hemisphere might be potentially useful therapeutically for post-stroke patients with spastic upper limb hemiparesis.
authors.affiliation: Department of Rehabilitation Medicine, Shimizu Hospital, Tottori, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kondo
authors.forename: W
authors.initials: W
authors.lastname: Kakuda
authors.forename: N
authors.initials: N
authors.lastname: Yamada
authors.forename: M
authors.initials: M
authors.lastname: Shimizu
authors.forename: H
authors.initials: H
authors.lastname: Hagino
authors.forename: M
authors.initials: M
authors.lastname: Abo
mesh_terms: D000368:Aged; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology*; D010291:Paresis / Q000209:etiology* / Q000628:therapy*; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications*; D050781:Transcranial Magnetic Stimulation; D034941:Upper Extremity / Q000503:physiopathology