title: Bilateral high- and low-frequency rTMS in acute stroke patients with hemiparesis: a comparative study with unilateral high-frequency rTMS.
abstract: BACKGROUND
  High- and low-frequency repetitive transcranial magnetic stimulation (HF-rTMS and LF-rTMS) has been shown to be beneficial for upper limb hemiparesis in patients with acute stroke. However, no study has examined the usefulness of bilateral application of HF- and LF-rTMS (BL-rTMS).
  
  
  METHODS
  Fifty-eight hemiparetic patients with acute stroke were randomly assigned into two groups: HF-rTMS group and BL-rTMS group. All patients were scheduled to receive five sessions of either HF-rTMS over the lesional hemisphere or BL-rTMS over both hemispheres for 5 days. Motor function of the affected upper limb was evaluated using the Brunnstrom Recovery Stage (BRS) for upper-limb and hand-fingers, grip strength and tapping frequency, before the first session and after the last session of rTMS.
  
  
  RESULTS
  Improvement of BRS for the upper limb and hand/finger was significantly greater in the BL-rTMS group than the HF-rTMS group (p < 0.01). Improvement in grip strength and tapping frequency was also greater in the BL-rTMS group, although the differences were not statistically significant.
  
  
  CONCLUSIONS
  The proposed BL-rTMS is safe and feasible and showed a greater improvement of BRS of the affected upper limb compared to HF-rTMS. This novel rTMS approach may be a useful intervention for hemiparetic patients with acute stroke.
authors.affiliation: Department of Rehabilitation Medicine, Tokyo Metropolitan Bokutoh Hospital , Tokyo , Japan and.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sasaki
authors.forename: Wataru
authors.initials: W
authors.lastname: Kakuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Abo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D020127:Recovery of Function; D020521:Stroke / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*
keywords: Neurological; rehabilitation; stroke; sub-acute care