Abstract
Background The purpose of this study was to evaluate the difference between the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) and that of continuous theta burst stimulation (cTBS), when each is combined with intensive occupational therapy (OT), in poststroke patients with upper limb hemiparesis. Materials and Methods The study subjects were 103 poststroke patients with upper limb hemiparesis, who were divided into two groups: the LF-rTMS group (n = 71) and the cTBS group (three pulse bursts at 50 Hz) (n = 32). Each subject received 12 sessions of repetitive transcranial magnetic stimulation of 2,400 pulses applied to the nonlesional hemisphere and 240-min intensive OT (two 60-min one-to-one training sessions and two 60-min self-training exercises) daily for 15 days. Motor function was evaluated using the Fugl-Meyer Assessment (FMA) and the performance time of the Wolf motor function test (WMFT) was determined on the days of admission and discharge. Results Both groups showed a significant increase in the FMA score and a short log performance time of the WMFT (p < 0.001), but the increase in the FMA score was higher in the LF-rTMS group than the cTBS group (p < 0.05). Conclusion We recommend the use of 2400 pulses of LF-rTMS/OT for 2 weeks as treatment for hemiparetic patients.
Highlights
The application of transcranial magnetic stimulation (TMS) to the cerebral cortex was first described in 1985 by Barker et al [1], who demonstrated that such stimulation increased the conduction of nerve impulses from the motor cortex to the spinal cord, and resulted in hand muscle contractions
Seventy-one patients admitted before February 2, 2013, received low-frequency repetitive transcranial magnetic stimulation (LF-Repetitive TMS (rTMS))/occupational therapy (OT), whereas 32 patients admitted after February 2, 2013, received continuous theta burst stimulation (cTBS)/OT
The treatment resulted in an increase in the score in both groups (LF-rTMS/OT: from 44.0 ± 13.2 to 49.8 ± 11.9 points, p < 0.001; cTBS/OT: from 45.7 ± 11.8 to 51.6 ± 9.6 points, p < 0.05)
Summary
The application of transcranial magnetic stimulation (TMS) to the cerebral cortex was first described in 1985 by Barker et al [1], who demonstrated that such stimulation increased the conduction of nerve impulses from the motor cortex to the spinal cord, and resulted in hand muscle contractions. The purpose of this study was to evaluate the difference between the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) and that of continuous theta burst stimulation (cTBS), when each is combined with intensive occupational therapy (OT), in poststroke patients with upper limb hemiparesis. The study subjects were 103 poststroke patients with upper limb hemiparesis, who were divided into two groups: the LF-rTMS group (n = 71) and the cTBS group (three pulse bursts at 50 Hz) (n = 32). Both groups showed a significant increase in the FMA score and a short log performance time of the WMFT (p < 0.001), but the increase in the FMA score was higher in the LF-rTMS group than the cTBS group (p < 0.05). We recommend the use of 2400 pulses of LF-rTMS/OT for 2 weeks as treatment for hemiparetic patients
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