Combining peripheral with transcranial magnetic stimulation in treating subacute stroke
10.3760/cma.j.cn421666-20240627-00527
- VernacularTitle:重复外周磁刺激联合健侧低频重复经颅磁刺激对亚急性脑卒中患者上肢运动功能的影响
- Author:
Yuejiao CAO
1
;
Weiguan CHEN
1
;
Zhidong HUANG
1
;
Dongyan ZHU
1
;
Liang WANG
1
;
Zhenzhen HAN
1
;
Huiyuan JI
1
;
Wei SHI
1
;
Hongjian LU
1
Author Information
1. 南通市第一人民医院康复医学科，南通 226000
- Publication Type:Journal Article
- Keywords:
Stroke;
Transcranial magnetic stimulation;
Peripheral magnetic stimulation;
Upper limb motor function
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2025;47(11):984-990
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of combining repeated peripheral (rPMS) and central transcranial magnetic stimulation (rTMS) in treating upper limb motor dysfunction after a stroke.Methods:Seventy-eight patients with upper limb motor dysfunction after a stroke were randomly divided into a control group, an rTMS group and a combined magnetic stimulation group, each of 26. All three groups underwent routine rehabilitation, while the rTMS group was repeatedly given low frequency transcranial magnetic stimulation of the M1 region on the unaffected side, and the combined group also received repeated peripheral magnetic stimulation at Erb′s point on the affected upper limb. There was one treatment session a day, 5 days a week for 3 weeks. Before and after the treatment, everyone′s upper limb motor function was quantified using the Fugl-Meyer upper extremity assessment (FMA-UE) and the Wolf motor function test (WMFT). Skill in the activities of daily living was quantified in terms of a Barthel index (BI). Motor recovery of the upper limbs and hands was assessed using Brunnstrom staging. The latency and amplitude of the motor evoked potentials (MEPs) in the subjects′ affected abductor pollicis brevis muscles were also recorded before and after the treatment. Pearson correlation coefficients quantified the correlation between the changes in FMA-UE scores and MEP amplitudes before and after the treatment in the three groups.Results:There were no significant differences among the three groups before the treatment. Afterward, however, the average FMA-UE, WMFT and BI scores, as well as the upper limb and hand Brunnstrom stages and the average MEP latencies and amplitudes of all the three groups had improved significantly. The combined group′s average results were then significantly better than the other two groups′ averages, except for the upper limb Brunnstrom stages. The increases in MEP amplitude were positively correlated with the increases in FMA-UE scores among the rTMS and the combined group, but there was no significant correlation between them in the control group.Conclusions:The combined application of rPMS and contralateral low frequency rTMS can effectively relieve motor dysfunction in the upper limbs in the early stages after a stroke.
