title: Effects of intermittent theta burst stimulation on spasticity after stroke.
abstract: Spasticity is a common cause of long-term disability in poststroke hemiplegic patients. We investigated whether intermittent theta burst stimulation (iTBS) could reduce upper-limb spasticity after a stroke. Fifteen hemiplegic stroke patients were recruited for a double-blind sham-controlled cross-over design study. A single session of iTBS or sham stimulation was delivered on the motor hotspot of the affected flexor carpi radialis muscle in a random and counterbalanced order with a 1-week interval. Modified Ashworth scale (MAS), modified Tardieu scale (MTS), H-wave/M-wave amplitude ratio, peak torque (PT), peak torque angle (PTA), work of affected wrist flexor, and rectified integrated electromyographic activity of the flexor carpi radialis muscle were measured before, immediately after, 30 min after, and 1 week after iTBS or sham stimulation. Repeated-measures analysis of variance showed a significant interaction between time and intervention for the MAS, MTS, PT, PTA, and rectified integrated electromyographic activity (P<0.05), indicating that these parameters were significantly improved by iTBS compared with sham stimulation. However, the H-wave/M-wave amplitude ratio and work were not affected. MAS and MTS significantly improved for at least 30 min after iTBS, but the other parameters only improved immediately after iTBS (P<0.05). In conclusion, iTBS on the affected hemisphere may help to reduce poststroke spasticity transiently.
authors.affiliation: aDepartment of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center bDepartment and Research Institute of Rehabilitation Medicine cDepartment of Physiology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Dae Hyun
authors.initials: DH
authors.lastname: Kim
authors.forename: Ji Cheol
authors.initials: JC
authors.lastname: Shin
authors.forename: Seungsoo
authors.initials: S
authors.lastname: Jung
authors.forename: Tae-Min
authors.initials: TM
authors.lastname: Jung
authors.forename: Deog Young
authors.initials: DY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001696:Biomechanical Phenomena / Q000502:physiology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D005542:Forearm / Q000503:physiopathology; D006429:Hemiplegia / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome