title: Effects of repetitive transcranial magnetic stimulation on motor recovery and motor cortex excitability in patients with stroke: a randomized controlled trial.
abstract: Repetitive transcranial magnetic stimulation (rTMS) changes the excitability of the motor cortex and thereby has the potential to enhance motor recovery after stroke. This randomized, sham-controlled, double-blind study was to compare the effects of high-frequency versus low-frequency rTMS on motor recovery during the early phase of stroke and to identify the neurophysiological correlates of motor improvements.
  
  
  
  A total of 69 first-ever ischemic stroke patients with motor deficits were randomly allocated to receive five daily sessions of 3-Hz ipsilesional rTMS, 1-Hz contralesional rTMS or sham rTMS in addition to standard physical therapy. Outcome measures included motor deficits, neurological scores and cortical excitability, which were assessed at baseline, after the intervention and at 3-month follow-up.
  
  
  
  The rTMS groups manifested greater motor improvements than the control group, which were sustained for at least 3 months after the end of the treatment sessions. 1-Hz rTMS over the unaffected hemisphere produced more profound effects than 3-Hz rTMS in facilitating upper limb motor performance. There was a significant correlation between motor function improvement and motor cortex excitability change in the affected hemisphere.
  
  
  
  Repetitive transcranial magnetic stimulation is a beneficial neurorehabilitative strategy for enhancing motor recovery in the acute and subacute phase after stroke.
authors.affiliation: Department of Neurology, Jinling Hospital, Second Military Medical University, Nanjing, China.
authors.forename: J
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: L
authors.initials: L
authors.lastname: Tian
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: W
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: J
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: G
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: M
authors.initials: M
authors.lastname: Ma
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: X
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: R
authors.initials: R
authors.lastname: Ye
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Yin
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: W
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China. yangfang021011@163.com.
authors.forename: F
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Neurology, Jinling Hospital, Second Military Medical University, Nanjing, China. xfliu2@vip.163.com.|Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China. xfliu2@vip.163.com.
authors.forename: X
authors.initials: X
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009044:Motor Cortex / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology
keywords: cortical excitability; interhemispheric inhibition; motor cortex; motor dysfunction; neurorehabilitative; repetitive transcranial magnetic stimulation; stroke