title: Current evidence on transcranial magnetic stimulation and its potential usefulness in post-stroke neurorehabilitation: Opening new doors to the treatment of cerebrovascular disease.
abstract: BACKGROUND
  Repetitive transcranial magnetic stimulation (rTMS) is a therapeutic reality in post-stroke rehabilitation. It has a neuroprotective effect on the modulation of neuroplasticity, improving the brain's capacity to retrain neural circuits and promoting restoration and acquisition of new compensatory skills.
  
  
  METHODS
  We conducted a literature search on PubMed and also gathered the latest books, clinical practice guidelines, and recommendations published by the most prominent scientific societies concerning the therapeutic use of rTMS in the rehabilitation of stroke patients. The criteria of the International Federation of Clinical Neurophysiology (2014) were followed regarding the inclusion of all evidence and recommendations.
  
  
  CONCLUSIONS
  Identifying stroke patients who are eligible for rTMS is essential to accelerate their recovery. rTMS has proven to be safe and effective for treating stroke complications. Functional brain activity can be optimised by applying excitatory or inhibitory electromagnetic pulses to the hemisphere ipsilateral or contralateral to the lesion, respectively, as well as at the level of the transcallosal pathway to regulate interhemispheric communication. Different studies of rTMS in these patients have resulted in improvements in motor disorders, aphasia, dysarthria, oropharyngeal dysphagia, depression, and perceptual-cognitive deficits. However, further well-designed randomized controlled clinical trials with larger sample size are needed to recommend with a higher level of evidence, proper implementation of rTMS use in stroke subjects on a widespread basis.
authors.affiliation: Servicio de Neurología, Clínica San Vicente, Madrid, España. Electronic address: pistolpete271285@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: León Ruiz
authors.affiliation: Departamento de Gerencia, Clínica San Vicente, Madrid, España.
authors.forename: M L
authors.initials: ML
authors.lastname: Rodríguez Sarasa
authors.affiliation: Departamento de Dirección de Gestión Sanitaria, Clínica San Vicente, Madrid, España.
authors.forename: L
authors.initials: L
authors.lastname: Sanjuán Rodríguez
authors.affiliation: Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Benito-León
authors.affiliation: Servicio de Neurología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: García-Albea Ristol
authors.affiliation: Servicio de Psiquiatría, Clínica San Vicente, Madrid, España; Departamento de Dirección Médica, Clínica San Vicente, Madrid, España.
authors.forename: S
authors.initials: S
authors.lastname: Arce Arce
mesh_terms: D006801:Humans; D000066530:Neurological Rehabilitation / Q000379:methods*; D020127:Recovery of Function; D020521:Stroke / Q000628:therapy*; D000071939:Stroke Rehabilitation / Q000379:methods*; D050781:Transcranial Magnetic Stimulation / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data
keywords: Afasia; Aphasia; Disfagia; Dysphagia; Estimulación magnética transcraneal; Ictus; Neuroplasticidad; Neuroplasticity; Neurorehabilitation; Neurorrehabilitación; Stroke; Transcranial magnetic stimulation