title: Magnetic stimulation and movement-related cortical activity for acute stroke with hemiparesis.
abstract: OBJECTIVE
  This double-blind, randomized, placebo-controlled study investigated the beneficial effects of repetitive transcranial magnetic stimulation (rTMS) to patients with motor paresis in acute subcortical stroke on functional recovery and electrophysiological measures.
  
  
  METHODS
  Twenty patients with acute stroke were randomized into real rTMS (n = 10) or sham (n = 10) groups. Patients received five daily sessions of rTMS with 1200 pulses at 1 Hz for 20 min or sham stimulation over the contralesional motor cortex. Movement-related cortical potential MRCP, consisting of the Bereitschaftpotential, negative slope (NS') and motor potential (MP), was recorded during self-paced wrist extension of the affected limb associated with assessment of the Fugl-Meyer assessment (FMA) of the upper extremity, the pegboard test and the grip strength before and after the rTMS session.
  
  
  RESULTS
  Real rTMS improved the FMA and pegboard test scores compared to the sham group in the affected hand. This improvement was associated with increases in the MP and NS' over the front-central sites in the ipsilesional hemisphere, whereas the sham group did not show significant changes in MRCP components by rTMS.
  
  
  CONCLUSIONS
  Our findings suggest that low-frequency rTMS to the contralesional motor cortex facilitates functional recovery of paretic limbs in acute stroke patients through enhancing the the neuronal activity of ipsilesional motor and pre-motor areas.
authors.affiliation: Department of Neurology, Faculty of Medicine, Shimane University, Izumo, Japan.|Department of Rehabilitation, Daisen Rehabilitation Hospital, Saihaku, Japan.
authors.forename: A
authors.identifier: http://orcid.org/0000-0003-0038-9418
authors.initials: A
authors.lastname: Matsuura
authors.affiliation: Department of Neurology, Faculty of Medicine, Shimane University, Izumo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Onoda
authors.affiliation: Department of Neurology, Faculty of Medicine, Shimane University, Izumo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Oguro
authors.affiliation: Department of Neurology, Faculty of Medicine, Shimane University, Izumo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology
keywords: acute stroke; motor recovery; movement-related cortical potential; repetitive transcranial magnetic stimulation