Effects of repetitive magnetic stimulation on the hemodynamics of cerebral cortex patients with upper limb motor dysfunction after an ischemic stroke as observed by using functional near-infrared spectroscopy
10.3760/cma.j.cn421666-20240422-00301
- VernacularTitle:基于功能性近红外光谱成像技术观察重复经颅磁刺激对缺血性脑卒中患者脑皮质血流动力学的影响
- Author:
Sha LI
1
;
Xinyi LI
1
;
Yifan BAI
1
;
Li ZHAO
1
;
Chunyan WANG
1
;
Chunxiao WAN
1
Author Information
1. 天津医科大学总医院康复医学科，天津 300052
- Publication Type:Journal Article
- Keywords:
Stroke;
Transcranial magnetic stimulation;
Functional near-infrared spectroscopy;
Motor cortex
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2024;46(12):1085-1090
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe any effect of repetitive transcranial magnetic stimulation (rTMS) on the hemodynamics of the cerebral cortex after an ischemic stroke using functional near-infrared spectroscopy (fNIRS).Methods:Twenty-six ischemic stroke survivors with upper limb motor dysfunction were assigned at random to an experimental group ( n=17) or a control group ( n=9). Both groups received conventional rehabilitation training, but the experimental group additionally received 20 minutes of rTMS at 10Hz applied over the supplementary motor area (SMA) of the affected side. The treatment was applied 5 times a week for 3 weeks. The control group received sham rTMS stimulation on the same schedule. Before and after the intervention, the motor function of the hemiplegic upper limb was evaluated in both groups using the Fugl-Meyer upper extremity assessment (FMA-UE). The concentration of oxyhemoglobin (HbO) in the primary sensorimotor cortex (SM1), the SMA and the premotor cortex (PMC) was measured using fNIRS. The FMA-UE scores were then tested for any significant correlation with the HbO concentrations. Results:After the intervention, the average FMA-UE scores had increased significantly in both groups, with significantly greater improvement in the experimental group. Among the experimental group a significant increase was also observed in the HbO concentration in channel 20 during the preparation period and in channel 31 during the task period, along with a significant decrease in it in the CL-SM1 and CL-(SMA+ PMC) during the task period. HbO concentration in channel 31 during the task period before the intervention was found to be significantly correlated with the changes in the experimental group′s FMA-UE scores.Conclusions:High-frequency rTMS of the SMA on the affected side can improve the motor functioning of a hemiplegic upper limb, promote activation of the local motor cortex on the lesioned side, and inhibit activation of the contralateral motor cortex. HbO concentration in channel 31 may predict these therapeutic effects.
