Inhibitory repetitive transcranial magnetic stimulation of the contralesional premotor and primary motor cortices facilitate poststroke motor recovery
| Autor: | Chin Yi Hsieh, Rai Chi Chan, Shih-Ching Yeh, Chih Pin Wang, Po Yi Tsai, Chien Chih Wang |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Stimulation Severity of Illness Index Functional Laterality Premotor cortex Physical medicine and rehabilitation Developmental Neuroscience Double-Blind Method Neuromodulation medicine Humans Stroke Motor skill Aged Motor Cortex Neural Inhibition Recovery of Function Middle Aged medicine.disease Transcranial Magnetic Stimulation Transcranial magnetic stimulation medicine.anatomical_structure Treatment Outcome Neurology Motor Skills Chronic Disease Female Neurology (clinical) Primary motor cortex Psychology Neuroscience Motor cortex |
| Zdroj: | Restorative neurology and neuroscience. 32(6) |
| ISSN: | 1878-3627 |
| Popis: | Purpose The premotor cortex plays a major role in motor planning and control, exhibiting hierarchical importance comparable to that of the primary motor cortex (M1). In this study, we compared the effects of cPMd modulation, which was achieved using inhibitory repetitive transcranial magnetic stimulation (rTMS), with those of contralesional M1 (cM1) modulation, to elucidate the roles of both regions on longitudinal motor recovery following a stroke. Methods Forty-four patients who had sustained hemiplegia for 3 to 12 months were randomly allocated to a cPMd group, cM1 group, or sham group and received 10 sessions of 1-Hz rTMS. The Medical Research Council (MRC) Scale, Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), and a cortical excitability test were administered pre- and post- rTMS intervention. Results cPMd modulation yielded significant improvements in MRC, FMA, and WMFT scores compared with sham stimulation and a significant effect on cortical excitability suppression equivalent to that of cM1 modulation, but engendered effects on motor improvement inferior to those of cM1 modulation. Conclusions In patients with chronic stroke, the cPMd can fulfill a role similar to that of the cM1 in interhemispheric imbalance, which can be ameliorated by applying inhibitory rTMS to achieve substantial motor restoration. |
| Databáze: | OpenAIRE |
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