High-frequency transcranial magnetic stimulation is more effective than lower frequencies in improving the upper limb function of stroke survivors
10.3760/cma.j.cn421666-20250425-00364
- VernacularTitle:高频经颅磁刺激对缺血性脑卒中患者上肢功能及其脑电功率谱密度的影响
- Author:
Wenxuan CUI
1
;
Chunfang WANG
;
Jiaqi CHEN
;
Ni HAN
;
Yijie ZHENG
;
Ying ZHANG
Author Information
1. 天津中医药大学研究生院，天津 301617
- Publication Type:Journal Article
- Keywords:
Transcranial magnetic stimulation;
Stroke;
Compensation models;
Upper limb function
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2025;47(11):978-983
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effect of transcranial magnetic stimulation (rTMS) of the contralesional hemisphere at different frequencies on the recovery of upper limb motor function after a moderate-to-severe ischemic stroke.Methods:The inter-hemisphere compensation model was applied along with electroencephalogram (EEG) power spectrum density measurements. Thirty stroke survivors were randomly assigned to a sham stimulation group ( n=9), a high-frequency stimulation group ( n=11) or a low-frequency stimulation group ( n=10). In addition to physical and pharmacological therapy, the low-frequency and high-frequency groups received 1Hz or 5Hz rTMS, while the sham group received sham stimulation. The rTMS was delivered over the contralesional (unaffected) hemisphere once daily for 20 minutes over 15 consecutive days. Before, as well as 7 and 15 days after the treatment, all of the subjects′ motor functioning was assessed using the Fugl-Meyer Assessment for the upper extremity (FMA-UE) and their ability in the activities of daily living was assessed using the modified Barthel Index (MBI). Resting-state EEGs with the eyes closed were also recorded, and absolute alpha power across the whole brain was calculated. Changes from baseline FMA-UE and MBI scores and absolute alpha power were analyzed using one-way and repeated-measures analysis of variance. Results:After the treatment, significant within-group improvements from baseline were observed in the FMA-UE scores, MBIs and absolute alpha power, except for absolute alpha power in the low-frequency and sham groups. The repeated-measures analysis of variance revealed significant time × group interactions for FMA-UE ( F=9.926, P≤0.001), MBI ( F=8.789, P≤0.001) and absolute alpha power ( F=4.511, P≤0.05). So the treatment effects varied among the groups. Post hoc Bonferroni-corrected comparisons showed that the high-frequency group exhibited significantly greater improvements from baseline in terms of all three indicators compared with the other two groups. Conclusions:High-frequency (5Hz) rTMS applied to the contralesional hemisphere produced greater improvement than low-frequency (1Hz) stimulation in the upper limb motor function of patients with moderate-to-severe stroke. These findings support the use of the interhemispheric compensation model to guide rTMS therapy, particularly for patients with FMA-UE scores below 43.
