title: Continuous theta-burst stimulation may improve visuospatial neglect via modulating the attention network: a randomized controlled study.
abstract: Visuospatial neglect (VSN) is devastating and common after stroke, and is thought to involve functional disturbance of the attention network. Non-invasive theta-burst stimulation (TBS) may help restore the normal function of attention network, therefore facilitating recovery from VSN.
  
  
  
  This study investigated the effects of continuous TBS on resting-state functional connectivity (RSFC) in the attention network, and behavioral performances of patients with VSN after stroke.
  
  
  
  Twelve patients were randomly assigned to receive 10-day cTBS of the left posterior parietal cortex delivered at 80% (the cTBS group), or 40% (the active control group) of the resting motor threshold. Both groups received daily visual scanning training and motor function treatment. Resting-state functional MRI (fMRI) and behavioral tests including line bisection test and star cancelation test were conducted at baseline and after the treatment.
  
  
  
  At baseline, the two groups showed comparable results in the resting-state fMRI experiments and behavioral tests. After treatment, the cTBS group showed lower functional connectivity between right temporoparietal junction (TPJ) and right anterior insula, and between right superior temporal sulcus and right anterior insula, as compared with the active control group; both groups showed improvement in the behavioral tests, with the cTBS group showing larger changes from baseline than the active control group.
  
  
  
  cTBS of the left posterior parietal cortex in patients with VSN may induce changes in inter-regional RSFC in the right ventral attention network. These changes may be associated with improved recovery of behavioral deficits after behavioral training. The TPJ and superior temporal sulcus may play crucial roles in recovery from VSN.
authors.affiliation: a Department of Rehabilitation , Xuanwu Hospital Capital Medical University , Beijing , P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Fu
authors.affiliation: a Department of Rehabilitation , Xuanwu Hospital Capital Medical University , Beijing , P.R. China.
authors.forename: Lei
authors.initials: L
authors.lastname: Cao
authors.affiliation: a Department of Rehabilitation , Xuanwu Hospital Capital Medical University , Beijing , P.R. China.
authors.forename: Yanming
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: a Department of Rehabilitation , Xuanwu Hospital Capital Medical University , Beijing , P.R. China.
authors.forename: Su
authors.initials: S
authors.lastname: Huo
authors.affiliation: a Department of Rehabilitation , Xuanwu Hospital Capital Medical University , Beijing , P.R. China.
authors.forename: JuBao
authors.initials: J
authors.lastname: Du
authors.affiliation: a Department of Rehabilitation , Xuanwu Hospital Capital Medical University , Beijing , P.R. China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhu
authors.affiliation: a Department of Rehabilitation , Xuanwu Hospital Capital Medical University , Beijing , P.R. China.
authors.forename: Weiqun
authors.initials: W
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D001288:Attention / Q000502:physiology*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D063132:Connectome / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D010468:Perceptual Disorders / Q000628:therapy*; D013028:Space Perception / Q000502:physiology*; D013826:Theta Rhythm / Q000502:physiology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D014796:Visual Perception / Q000502:physiology*
keywords: Continuous theta-burst stimulation (cTBS); Dorsal attention network; Posterior parietal cortex; Resting-state functional connectivity; Stroke; Ventral attention network; Visuospatial neglect (VSN)