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Improvement of dexterity by single session low-frequency repetitive transcranial magnetic stimulation over the contralesional motor cortex in acute stroke: a double-blind placebo-controlled crossover trial.
Restor Neurol Neurosci. 2007; 25(5-6):461-5.RN

Abstract

PURPOSE

Increasing evidence suggests that the contralesional motor cortex (M1) inhibits the ipsilesional M1 in stroke patients. This inhibition could impair motor function of the affected hand. We investigated if inhibitory 1~Hz repetitive transcranial magnetic stimulation (rTMS) over the contralesional M1 improved motor performance of the affected hand in acute stroke.

METHODS

A double-blind study of real versus placebo rTMS was conducted. Twelve patients early after subcortical stroke (mean: 7 days) received 1200 stimuli of real and placebo rTMS in a crossover design. The sequence of stimulations was counterbalanced across subjects. Stimulus intensity was subthreshold (90% of motor threshold at rest). Motor function was tested by grip strength recordings and Nine Hole Peg Test (NHPT) executions before and after each rTMS session.

RESULTS

Compared to sham stimulation, real rTMS improved NHPT results but not grip strength in the affected hand. No change of performance was observed for the unaffected hand. NHPT baseline repetitions in a subgroup of patients indicated stable motor performance prior to the rTMS sessions.

CONCLUSIONS

The study suggests that therapeutic rTMS applications over the contralesional hemisphere are feasible in acute stroke patients and can transiently improve dexterity of the affected hand. RTMS may become an additional tool for early neurorehabilitation.

Authors+Show Affiliations

Department of Neurology, University Hospital, Freiburg, Germany. j.liepert@kliniken-schmieder.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18334764

Citation

Liepert, Joachim, et al. "Improvement of Dexterity By Single Session Low-frequency Repetitive Transcranial Magnetic Stimulation Over the Contralesional Motor Cortex in Acute Stroke: a Double-blind Placebo-controlled Crossover Trial." Restorative Neurology and Neuroscience, vol. 25, no. 5-6, 2007, pp. 461-5.
Liepert J, Zittel S, Weiller C. Improvement of dexterity by single session low-frequency repetitive transcranial magnetic stimulation over the contralesional motor cortex in acute stroke: a double-blind placebo-controlled crossover trial. Restor Neurol Neurosci. 2007;25(5-6):461-5.
Liepert, J., Zittel, S., & Weiller, C. (2007). Improvement of dexterity by single session low-frequency repetitive transcranial magnetic stimulation over the contralesional motor cortex in acute stroke: a double-blind placebo-controlled crossover trial. Restorative Neurology and Neuroscience, 25(5-6), 461-5.
Liepert J, Zittel S, Weiller C. Improvement of Dexterity By Single Session Low-frequency Repetitive Transcranial Magnetic Stimulation Over the Contralesional Motor Cortex in Acute Stroke: a Double-blind Placebo-controlled Crossover Trial. Restor Neurol Neurosci. 2007;25(5-6):461-5. PubMed PMID: 18334764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improvement of dexterity by single session low-frequency repetitive transcranial magnetic stimulation over the contralesional motor cortex in acute stroke: a double-blind placebo-controlled crossover trial. AU - Liepert,Joachim, AU - Zittel,Simone, AU - Weiller,Cornelius, PY - 2008/3/13/pubmed PY - 2008/6/13/medline PY - 2008/3/13/entrez SP - 461 EP - 5 JF - Restorative neurology and neuroscience JO - Restor Neurol Neurosci VL - 25 IS - 5-6 N2 - PURPOSE: Increasing evidence suggests that the contralesional motor cortex (M1) inhibits the ipsilesional M1 in stroke patients. This inhibition could impair motor function of the affected hand. We investigated if inhibitory 1~Hz repetitive transcranial magnetic stimulation (rTMS) over the contralesional M1 improved motor performance of the affected hand in acute stroke. METHODS: A double-blind study of real versus placebo rTMS was conducted. Twelve patients early after subcortical stroke (mean: 7 days) received 1200 stimuli of real and placebo rTMS in a crossover design. The sequence of stimulations was counterbalanced across subjects. Stimulus intensity was subthreshold (90% of motor threshold at rest). Motor function was tested by grip strength recordings and Nine Hole Peg Test (NHPT) executions before and after each rTMS session. RESULTS: Compared to sham stimulation, real rTMS improved NHPT results but not grip strength in the affected hand. No change of performance was observed for the unaffected hand. NHPT baseline repetitions in a subgroup of patients indicated stable motor performance prior to the rTMS sessions. CONCLUSIONS: The study suggests that therapeutic rTMS applications over the contralesional hemisphere are feasible in acute stroke patients and can transiently improve dexterity of the affected hand. RTMS may become an additional tool for early neurorehabilitation. SN - 0922-6028 UR - https://www.unboundmedicine.com/medline/citation/18334764/Improvement_of_dexterity_by_single_session_low_frequency_repetitive_transcranial_magnetic_stimulation_over_the_contralesional_motor_cortex_in_acute_stroke:_a_double_blind_placebo_controlled_crossover_trial_ L2 - https://facultyopinions.com/pubmed/18334764 DB - PRIME DP - Unbound Medicine ER -