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.

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.

Objective:To observe the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation com-bined with rehabilitation robot on hand dysfunction in stroke patients. Method:Totally 36 patients with stroke hand dysfunction treated in the Rehabilitation Department of Jinshan Hospital were randomly divided into the experimental group(n=18)and the control group(n=18).Both groups of patients received routine treatment.Both groups were treated with 1Hz repetitive transcranial magnet-ic stimulation on the unaffected side,and the experimental group was added by a hand function rehabilitation robot.Both groups were treated 5 times a week for 4 weeks.The assessment were evaluated before treatment,2 weeks and 4 weeks after treatment,including the latency of cortical motor evoked potential(MEP),central motor conduction time(CMCT),Fugl-Meyer assessment(FMA)score and motor intensity index(MI)score. Result:After 4 weeks of treatment,MEP,CMCT,FMA and MI of the two groups were significantly im-proved compared with those before treatment(P＜0.001).After 4 weeks of treatment,MEP,CMCT,FMA and MI in the experimental group were significantly improved compared with those in the control group(P＜0.05). Conclusion:The contralateral low-frequency repetitive transcranial magnetic stimulation combined with rehabilita-tion robot can significantly improve hand dysfunction in stroke patients.

Objective:To observe the effect of electroacupuncture(EA)combined with repetitive transcranial magnetic stimulation(rTMS)on limb dysfunction in ischemic stroke patients. Methods:A total of 63 stroke patients were divided into an observation group and a control group using the random number table method.Thirty-one patients in the control group were treated with routine Western medicine combined with rTMS;32 patients in the observation group were treated with EA in addition to the intervention in the control group.The duration of treatment was 3 months.The National Institutes of Health stroke scale(NIHSS),the Fugl-Meyer assessment(FMA),the modified Barthel index(MBI),and the motor evoked potential(MEP)latency of transcranial magnetic stimulation were observed before and after treatment in both groups. Results:Two cases withdrew from the observation group and 1 case withdrew from the control group.After treatment,the NIHSS score in both groups was lower than that before treatment,the FMA and MBI scores were higher than those before treatment,and the latency period of MEP was shorter than that before treatment,and the differences were statistically significant(P<0.05).After treatment,the NIHSS,FMA,and MBI scores and MEP latency period of the observation group improved more than those of the control group,and the differences between the groups were statistically significant(P<0.05). Conclusion:EA combined with rTMS can improve the motor function of limbs in ischemic stroke patients and improve their self-care ability.The mechanism may be related to increasing the excitability of the motor cortex and improving the electrophysiological function of the central nervous system.

ObjectiveTo investigate the effect of 1 Hz repetitive transcranial magnetic stimulation (rTMS) combined with mirror therapy on upper limb motor function and cortical neurophysiological indicators in stroke patients with hemiplegia. MethodsSixty stroke patients who were admitted to Jinshan Hospital of Fudan University, from October, 2022 to March, 2023 were randomly assigned to control group (n = 15), rTMS group (n = 15), mirror therapy group (n = 15) and combined group (n = 15). All groups received routine medicine and rehabilitation. In addition, the control group received sham rTMS and sham mirror therapy, rTMS group received 1 Hz rTMS and sham mirror therapy, the mirror therapy group received sham rTMS and mirror therapy, and the combined group received 1Hz rTMS combined with mirror therapy, for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Action Research Arm Test (ARAT) were used to evaluate the motor function of the affected upper limb. The motor-evoked potential (MEP) amplitude and central motor conduction time (CMCT) of the affected cortex were measured using a transcranial magnetic stimulation device. ResultsAfter treatment, the scores of FMA-UE and ARAT, and the amplitude of MEP significantly improved in all groups (|t| > 3.854, P < 0.001), while the CMCT significantly shortened (t > 5.967, P < 0.001). Compared to the control group, rTMS group, the mirror therapy group and the combined group showed more significant improvement in the scores of FMA-UE and ARAT, and the amplitude of MEP, and shorter CMCT (P < 0.05). When compared to rTMS group and the mirror therapy group, the combined group showed more significant improvement the scores of FMA-UE and ARAT, and the amplitude of MEP, and shorter CMCT (P < 0.05). There was significant positive correlation of the scores of FMA-UE and ARAT with the amplitude of MEP, and negative correlation with the CMCT in all groups (R² > 0.804, P < 0.001). ConclusionThe combination of 1 Hz rTMS and mirror therapy contributes to the post-stroke brain functional remodeling and facilitates upper limb motor recovery in stroke patients with hemiplegia.