Corticospinal tract integrity and the upper limb motor functioning of stroke survivors treated with repetitive transcranial magnetic stimulation
10.3760/cma.j.issn.0254-1424.2022.06.005
- VernacularTitle:基于双峰平衡恢复模型探究重复经颅磁刺激治疗脑卒中患者上肢运动功能障碍
- Author:
Lu WANG
1
;
Minghua ZHONG
;
Chengfei GAO
;
Qixiu ZHU
;
Ruizhi ZHOU
;
Xiqin LIU
;
Naisu TANG
;
Xiaochen FENG
Author Information
1. 青岛大学附属医院康复医学科，青岛 266000
- Keywords:
Stroke;
Corticospinal tract;
Diffusion tensor imaging;
Transcranial magnetic stimulation
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2022;44(6):503-508
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe any relationship between corticospinal tract integrity and the upper limb motor function of stroke survivors treated with repetitive transcranial magnetic stimulation (rTMS).Methods:Bilateral corticospinal tracts (CSTs) were reconstructed in ischemic or hemorrhagic stroke survivors with upper limb motor dysfunction using diffusion tensor imaging (DTI). Thirty patients with good CST integrity (rFA>0.5) and 30 with rFA≤0.5 were further divided into a high frequency rTMS group (HF, n=10), a low frequency group (LF, n=10), and a control group ( n=10). All groups were given routine rehabilitation, while the high and low frequency groups were additionally provided with 5Hz and 1Hz rTMS respectively applied over the M1 area of the contralesional hemisphere. Before and after 3 weeks of treatment, all of the subjects were evaluated using the Fugl-Meyer upper extremity scale (F-M UE), the Wolf Motor Function Test (WMFT) and the Modified Barthel Index (MBI). Results:For the high CST integrity group, significant improvement was observed in the average scores of all measurements, with the average FMA-UE, WMFT and MBI scores of the LF group [(38.10±5.71), (43.20±5.32) and (78.00±11.35)] significantly better than those of the other 2 groups. Among the low CST integrity group, the HF subgroup showed greater improvement than the other 2 on average.Conclusions:For patients with good CST integrity, LF-rTMS over the contralesional cortex is superior to HF-rTMS in promoting upper limb motor function, while for patients with low CST integrity HF-rTMS over the contralesional cortex has a better effect than LF-rTMS or sham stimulation in terms of improving upper limb motor function after a stroke.
