The effects of cerebellar theta burst stimulation in different modes combined with cortical magnetic stimu-lation in the treatment of upper limb spasticity after stroke
10.3969/j.issn.1001-1242.2025.06.009
- VernacularTitle:不同模式小脑θ爆发刺激联合皮层磁刺激治疗脑卒中后上肢痉挛的疗效观察
- Author:
Benmei CHEN
1
;
Mulei QIU
1
;
Dan WU
1
Author Information
1. 复旦大学附属金山医院康复医学科,上海市,201508
- Publication Type:Journal Article
- Keywords:
stroke;
upper limb;
spasticity;
transcranial magnetic stimulation;
cerebellum
- From:
Chinese Journal of Rehabilitation Medicine
2025;40(6):861-867
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the impact of different modes of cerebellar theta burst stimulation combined with 1Hz repetitive transcranial magnetic stimulation of the contralateral cerebral cortex on upper limb spasticity in stroke hemiplegic patients.Method:Sixty stroke patients in the recovery stage,who were admitted to Jinshan Hospital affiliated with Fu-dan University between Nov.2023 and Nov.2024 and met the predefined inclusion and exclusion criteria,were selected.These patients were then randomly allocated to three groups:the control group(n=20),the iT-BS group(n=20),and the cTBS group(n=20).All three groups received conventional medical therapy and rou-tine rehabilitation regimens.Additionally,the control group was administered 1Hz repetitive transcranial magnet-ic stimulation(rTMS)on the contralesional cerebral cortex,along with random sham transcranial magnetic stim-ulation(TBS)of the cerebellum.The iTBS group was subjected to 1Hz rTMS on the contralesional cerebral cortex,combined with intermittent theta-burst stimulation(iTBS)of the cerebellum.Similarly,the cTBS group received 1Hz rTMS on the contralesional cerebral cortex,in conjunction with continuous theta-burst stimulation(cTBS)of the cerebellum.Prior to treatment initiation and four weeks post-treatment,the Modified Ashworth Scale(MAS)was applied to assess the muscle tone of the affected upper limb.The Fugl-Meyer Assessment for Upper Extremity(FMA-UE)was utilized to evaluate the motor function of the affected upper limb.More-over,a transcranial magnetic stimulation device was employed to measure the motor evoked potential(MEP)amplitude and central motor conduction time(CMCT)of the affected cerebral cortex.Result:No statistically significant differences were observed among the three groups in terms of MAS scores,FMA-UE scores,MEP amplitudes,and CMCT values prior to the treatment(P＞0.05).After four weeks of treatment,a significant decrease in MAS scores was observed in all three groups(|t|>5.101,P＜0.001).Simulta-neously,significant increases in FMA-UE scores(|t|>4.621,P＜0.001)and MEP amplitudes(|t|>3.530,P＜0.05),as well as a significant shortening of CMCT values(|t|>4.969,P＜0.001)were detected.Further pairwise com-parisons indicated that,compared with the control group,the other two groups showed more significant de-creases in MAS scores,more substantial increases in FMA-UE scores and MEP amplitudes,and more pro-nounced shortening of CMCT values post-treatment(P＜0.05).After treatment,no statistically significant differ-ences were found between the iTBS group and the cTBS group in MAS scores,FMA-UE scores,MEP ampli-tudes,and CMCT values(P＞0.05).Conclusion:Both different modes of cerebellar theta-burst stimulation combined with 1Hz repetitive transcrani-al magnetic stimulation on the contralateral cerebral cortex are helpful in alleviating the spasticity of the hemi-plegic upper limb in stroke patients and promoting the recovery of upper limb motor function.
