Effects of low frequency repetitive transcranial magnetic stimulation at different stimulating sessions on upper limb motor function and brain functional connectivity in stroke patients
10.3969/j.issn.1001-1242.2024.10.005
- VernacularTitle:不同治疗时程的重复经颅磁刺激对脑卒中患者上肢运动功能及脑功能连接的影响
- Author:
Yuan PENG
1
;
Xi-Bin ZHANG
;
Weiwen MEI
Author Information
1. 广州市第一人民医院康复医学科,广东省广州市,510180
- Keywords:
repetitive transcranial magnetic stimulation;
ischemic stroke;
upper limb motor function;
premotor cortex;
functional connectivity
- From:
Chinese Journal of Rehabilitation Medicine
2024;39(10):1436-1442
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of repeated transcranial magnetic stimulation(rTMS)at different stimulating sessions on upper limb motor function and brain functional connectivity in stroke patients,targeting on stimu-late the contralateral premotor cortex(PMC). Method:Sixty patients with upper limb motor dysfunction after ischemic stroke were randomly assigned to 6-week rTMS group,4-week rTMS group,2-week rTMS group or control group,each with 15 participants.Up-per limb Brunnstrom stage,Fugl-Meyer assessment for upper extremity(FMA-UE)and Wolf motor function test(WMFT)were assessed before and after treatment to evaluate behavioral outcomes.The functional connec-tivity was analyzed by resting state functional magnetic resonance imaging(rs-fMRI)with the contralateral PMC as the seed point. Result:After treatment,the FMA-UE and WMFT scores of the 2-week rTMS group were significantly differ-ent from those of the 4-week and 6-week rTMS groups(P＜0.05),but there was no significant difference be-tween the 4-week rTMS group and the 6-week rTMS group(P＞0.05).Functional connectivity analysis using contralateral PMC as a seed point showed that functional connections were enhanced between contralateral PMC and ipsilateral anterior central gyrus,as well as the contralateral middle temporal gyrus and precuneus af-ter rTMS treatment(P＜0.05). Conclusion:The 4-week rTMS group has the best duration-benefit compared with the 2-week rTMS group and the 6-week rTMS group.The probable mechanism was related to that rTMS treatment could reduce the ef-fect of interhemispheric inhibition on motor cortex,and then enhance the cortico-cortical functional connectivi-ty in the contralateral hemisphere effectively,resulting in the recovery of upper limb motor function.
