Preliminary study of rTMS combined with rPMS on upper limb function and motor cortex excitability post stroke
10.3969/j.issn.1001-1242.2025.03.007
- VernacularTitle:低频重复经颅磁刺激联合重复外周磁刺激对脑卒中患者上肢功能和大脑皮层兴奋性影响的初步研究
- Author:
Qilin CHENG
1
;
Yuanwen LIU
1
;
Shuxian ZHANG
1
Author Information
1. 中山大学附属第三医院康复医学科,广东省 广州市,510630
- Publication Type:Journal Article
- Keywords:
stroke;
upper limb motor function;
spasticity;
repetitive transcranial magnetic stimulation;
repeti-tive peripheral magnetic stimulation;
functional near-infrared spectroscopy
- From:
Chinese Journal of Rehabilitation Medicine
2025;40(3):361-368
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of low-frequency repetitive transcranial magnetic stimulation(rTMS)com-bined with repetitive peripheral magnetic stimulation(rPMS)on upper limb function and cortical excitability of stroke.Method:Thirty-five patients with upper limb dysfunction in stroke admitted to the Department of Rehabilita-tion Medicine of the Third Affiliated Hospital of Sun Yat-sen University from November 2021 to November 2022 were selected.They were randomly divided into experimental group(n=17)and control group(n=17).Both groups received conventional rehabilitation therapy and low-frequency rTMS.The experimental group re-ceived additional rPMS for the affected upper extremity extensors,while the control group received sham rPMS.Both groups received Fugl-Meyer assessment of the upper extremity(FMA-UE),modified Ashworth scale(MAS),modified Barthel index(MBI),rest motor threshold(rMT)assessments.23 patients underwent fNIRS to detect changes in oxyhemoglobin concentration(HbO2)in bilateral premotor and supplementary mo-tor cortex(PMC-SMA)and sensorimotor cortex(SMC)before and after treatment.Result:FMA-UE and MBI were significantly improved in both groups(P＜0.05),and the improvement of FMA-UE and the rMT of unaffected Ml were significantly higher in the experimental group than in the con-trol group after treatment(P＜0.05);the MAS grade of the flexor elbow group and Δ HbO2 of the affected SMC were significantly improved in the experimental group(P＜0.05),and the improvement of FMA-UE was correlated with the increase of the rMT of unaffected Ml and ΔHbO2 of the affected SMC(P＜0.05).There was no statistically significant difference for the MAS grade of elbow extension and wrist flexion muscle groups,ΔHbO2 of bilateral PMC-SMA area,and ΔHbO2 of unaffected SMC area(P＞0.05).Conclusion:The combination of rTMS and rPMS improved upper limb function and activities of daily living and modulated cortical excitability in stroke patients,This combination was more effective than rTMS alone,likely due to the reduced excitability of the unaffected Ml and the activation of the affected SMC.
