Ann Rehabil Med.  2014 Oct;38(5):585-591. 10.5535/arm.2014.38.5.585.

Comparison of the Effects of 1 Hz and 20 Hz rTMS on Motor Recovery in Subacute Stroke Patients

Affiliations
  • 1Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea. s3034@paik.ac.kr
  • 2Department of Rehabilitation Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.

Abstract


OBJECTIVE
To compare the low frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) with high frequency (20 Hz) rTMS on motor functional improvement of the affected upper extremity in subacute stroke patients.
METHODS
Forty patients with subacute ischemic stroke participated in this study. The first group received 10 sessions of 20 Hz rTMS at ipsilesional M1 area and the other group received 10 sessions of 1 Hz rTMS at contralesional M1 area. Motor training of the hemiparetic hand was conducted after each rTMS train. All the patients received conventional occupational therapy immediately after each rTMS session. Manual function test (MFT), Fugl-Meyer Assessment scale (FMS), Modified Barthel Index (MBI), Brunnstrom recovery stage, and grip strength were used to assess motor function before, at the end of, and one month after the last session of rTMS.
RESULTS
No adverse side effects were reported during the course of the experiment using rTMS. No significant difference in motor function of the affected upper extremity was observed between the two groups before rTMS. Significant improvements in MFT, FMS, MBI, and Brunnstrom stage were observed in the both groups at the end of the last rTMS session and one month later (p<0.05). No significant difference was found between the two groups (p>0.05).
CONCLUSION
There was no significant difference in motor function of the affected upper extremity between 1 Hz and 20 Hz rTMS during the subacute period of ischemic stroke. Thus, we cannot conclude which has a greater effect.

Keyword

Transcranial magnetic stimulation; Stroke; Motor recovery

MeSH Terms

Hand
Hand Strength
Humans
Occupational Therapy
Stroke*
Transcranial Magnetic Stimulation
Upper Extremity

Cited by  1 articles

Factors Associated With Upper Extremity Functional Recovery Following Low-Frequency Repetitive Transcranial Magnetic Stimulation in Stroke Patients
Seo Young Kim, Sung Bong Shin, Seong Jae Lee, Tae Uk Kim, Jung Keun Hyun
Ann Rehabil Med. 2016;40(3):373-382.    doi: 10.5535/arm.2016.40.3.373.


Reference

1. Turhan N, Atalay A, Atabek HK. Impact of stroke etiology, lesion location and aging on post-stroke urinary incontinence as a predictor of functional recovery. Int J Rehabil Res. 2006; 29:335–338. PMID: 17106352.
Article
2. Jongbloed L. Prediction of function after stroke: a critical review. Stroke. 1986; 17:765–776. PMID: 3526649.
Article
3. Keren O, Ring H, Solzi P, Pratt H, Groswasser Z. Upper limb somatosensory evoked potentials as a predictor of rehabilitation progress in dominant hemisphere stroke subjects. Stroke. 1993; 24:1789–1793. PMID: 8248956.
4. Kim DY, Park CI, Jung KJ, Ohn SH, Park KD, Park JB, et al. Improvement of chronic post-stroke hemiparetic upper limb function after 2 week trascranial direct current stimulation. J Korean Acad Rehabil Med. 2009; 33:5–11.
5. Alonso-Alonso M, Fregni F, Pascual-Leone A. Brain stimulation in poststroke rehabilitation. Cerebrovasc Dis. 2007; 24(Suppl 1):157–166. PMID: 17971652.
Article
6. Mansur CG, Fregni F, Boggio PS, Riberto M, Gallucci-Neto J, Santos CM, et al. A sham stimulation-controlled trial of rTMS of the unaffected hemisphere in stroke patients. Neurology. 2005; 64:1802–1804. PMID: 15911819.
Article
7. Khedr EM, Ahmed MA, Fathy N, Rothwell JC. Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke. Neurology. 2005; 65:466–468. PMID: 16087918.
Article
8. Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci. 2004; 22:281–299. PMID: 15502272.
9. Fregni F, Boggio PS, Valle AC, Rocha RR, Duarte J, Ferreira MJ, et al. A sham-controlled trial of a 5-day course of repetitive transcranial magnetic stimulation of the unaffected hemisphere in stroke patients. Stroke. 2006; 37:2115–2122. PMID: 16809569.
Article
10. Peinemann A, Reimer B, Loer C, Quartarone A, Munchau A, Conrad B, et al. Long-lasting increase in corticospinal excitability after 1800 pulses of subthreshold 5 Hz repetitive TMS to the primary motor cortex. Clin Neurophysiol. 2004; 115:1519–1526. PMID: 15203053.
Article
11. Fitzgerald PB, Fountain S, Daskalakis ZJ. A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition. Clin Neurophysiol. 2006; 117:2584–2596. PMID: 16890483.
Article
12. Kim YH, You SH, Ko MH, Park JW, Lee KH, Jang SH, et al. Repetitive transcranial magnetic stimulation-induced corticomotor excitability and associated motor skill acquisition in chronic stroke. Stroke. 2006; 37:1471–1476. PMID: 16675743.
Article
13. Kirton A, Chen R, Friefeld S, Gunraj C, Pontigon AM, Deveber G. Contralesional repetitive transcranial magnetic stimulation for chronic hemiparesis in subcortical paediatric stroke: a randomised trial. Lancet Neurol. 2008; 7:507–513. PMID: 18455961.
Article
14. Counsell C, Dennis M, McDowall M, Warlow C. Predicting outcome after acute and subacute stroke: development and validation of new prognostic models. Stroke. 2002; 33:1041–1047. PMID: 11935058.
15. Cramer SC. Repairing the human brain after stroke. II. Restorative therapies. Ann Neurol. 2008; 63:549–560. PMID: 18481291.
Article
16. Munoz Maniega S, Cvoro V, Chappell FM, Armitage PA, Marshall I, Bastin ME, et al. Changes in NAA and lactate following ischemic stroke: a serial MR spectroscopic imaging study. Neurology. 2008; 71:1993–1999. PMID: 19064881.
Article
17. Wassermann EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996. Electroencephalogr Clin Neurophysiol. 1998; 108:1–16. PMID: 9474057.
Article
18. Miyamoto S, Kondo T, Suzukamo Y, Michimata A, Izumi S. Reliability and validity of the Manual Function Test in patients with stroke. Am J Phys Med Rehabil. 2009; 88:247–255. PMID: 19106794.
Article
19. Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med. 1975; 7:13–31. PMID: 1135616.
20. Wade DT, Skilbeck CE, Hewer RL. Predicting Barthel ADL score at 6 months after an acute stroke. Arch Phys Med Rehabil. 1983; 64:24–28. PMID: 6849630.
21. Safaz I, Yilmaz B, Yasar E, Alaca R. Brunnstrom recovery stage and motricity index for the evaluation of upper extremity in stroke: analysis for correlation and responsiveness. Int J Rehabil Res. 2009; 32:228–231. PMID: 19339892.
Article
22. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985; 66:69–74. PMID: 3970660.
23. Hummel FC, Cohen LG. Non-invasive brain stimulation: a new strategy to improve neurorehabilitation after stroke? Lancet Neurol. 2006; 5:708–712. PMID: 16857577.
Article
24. Vang C, Dunbabin D, Kilpatrick D. Correlation between functional and electrophysiological recovery in acute ischemic stroke. Stroke. 1999; 30:2126–2130. PMID: 10512917.
Article
25. Yozbatiran N, Alonso-Alonso M, See J, Demirtas-Tatlidede A, Luu D, Motiwala RR, et al. Safety and behavioral effects of high-frequency repetitive transcranial magnetic stimulation in stroke. Stroke. 2009; 40:309–312. PMID: 18845801.
Article
26. Valle AC, Dionisio K, Pitskel NB, Pascual-Leone A, Orsati F, Ferreira MJ, et al. Low and high frequency repetitive transcranial magnetic stimulation for the treatment of spasticity. Dev Med Child Neurol. 2007; 49:534–538. PMID: 17593127.
Article
27. Chang WH, Kim YH, Bang OY, Kim ST, Park YH, Lee PK. Long-term effects of rTMS on motor recovery in patients after subacute stroke. J Rehabil Med. 2010; 42:758–764. PMID: 20809058.
Article
28. Gershon AA, Dannon PN, Grunhaus L. Transcranial magnetic stimulation in the treatment of depression. Am J Psychiatry. 2003; 160:835–845. PMID: 12727683.
Article
29. Khedr EM, Etraby AE, Hemeda M, Nasef AM, Razek AA. Long-term effect of repetitive transcranial magnetic stimulation on motor function recovery after acute ischemic stroke. Acta Neurol Scand. 2010; 121:30–37. PMID: 19678808.
Article
30. Sasaki N, Mizutani S, Kakuda W, Abo M. Comparison of the effects of high- and low-frequency repetitive transcranial magnetic stimulation on upper limb hemiparesis in the early phase of stroke. J Stroke Cerebrovasc Dis. 2013; 22:413–418. PMID: 22177936.
Article
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