Abstract
This study was conducted in Tuen Mun Hospital (TMH) to evaluate the effects of rTMS and tDCS on upper limb functional recovery in acute stroke patients. Patients with acute stroke were randomly assigned to rTMS, tDCS or control group. For rTMS group, patient received 1 Hz rTMS at 90% of resting motor threshold to M1 of the unaffected hemisphere for 1200 pulses. For tDCS group, patient received 1 mA anodal stimulation to hand area of the affected hemisphere for 20 minutes. Five consecutive sessions of rTMS or tDCS together with intensive physiotherapy upper limb training were given. For control group, only intensive physiotherapy upper limb training were given. The upper extremity section of Fugl–Meyer Scale (UE-FM) was used as outcome measure. Twenty-nine patients (17 female and 12 male) were assigned to the rTMS ( n = 9), tDCS ( n = 11) and control ( n = 9) group. The mean age was 62.7 ± 12.0 years old and the mean time between stroke onset and the first UE-FM assessment was 9.14 ± 3.30 days. There was no statistically significant difference in mean age, baseline UE-FM mean score, mean time between stroke onset and the first UE-FM assessment among three groups [X 2 (2) = 4.81, P = 0.09] [X 2 (2) = 1.56, P = 0.457] [X 2 (2) = 0.04, P = 0.98]. No adverse effects of rTMS or tDCS were reported. For between-group comparison, the changes in mean score of UE-FM in rTMS (20.8 ± 6.59) and tDCS group (16.1 ± 4.97) were statistically significantly larger than that in control group (10.6 ± 4.13) (U = −2.97, P = 0.002) (U = −2.29, P = 0.02). However, there was no significant difference between rTMS and tDCS group (U = −1.49, P = 0.152). Findings of the present study showed that both rTMS and tDCS could augment physiotherapy treatment in enhancing upper limb motor functional recovery in acute stroke patients. These positive findings warrant further investigation of the application of non-invasive brain stimulation techniques to neurorehabilitation.
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