Current evidence, clinical applications, and future directions of transcranial magnetic stimulation as a treatment for ischemic stroke

Frontiers in Neuroscience, Journal Year: 2023, Volume and Issue: 17

Published: July 18, 2023

Transcranial magnetic stimulation (TMS) is a non-invasive brain neurostimulation technique that can be used as one of the adjunctive treatment techniques for neurological recovery after stroke. Animal studies have shown TMS rats with middle cerebral artery occlusion (MCAO) model reduced infarct volume and improved dysfunction in rats. In addition, clinical case reports also has positive neuroprotective effects stroke patients, improving variety post-stroke deficits such motor function, swallowing, cognitive speech central pain, spasticity, other sequelae. However, even though numerous effect its possible mechanism not clear. Therefore, this review, we describe potential mechanisms to improve function terms neurogenesis, angiogenesis, anti-inflammation, antioxidant, anti-apoptosis, provide insight into current application multiple dysfunctions Finally, some challenges faced by are summarized suggestions future research directions made.

Language: Английский

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Transcutaneous auricular vagus nerve stimulation with task-oriented training improves upper extremity function in patients with subacute stroke: a randomized clinical trial

Frontiers in Neuroscience, Journal Year: 2024, Volume and Issue: 18

Published: March 8, 2024

Background Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising brain modality in poststroke upper extremity rehabilitation. Although several studies have examined the safety and reliability of taVNS, mechanisms underlying motor recovery stroke patients remain unclear. Objectives This study aimed to investigate effects taVNS paired with task-oriented training (TOT) on function subacute explore potential mechanisms. Methods In this double-blinded, randomized, controlled pilot trial, 40 were randomly assigned two groups: VNS group (VG), receiving during TOT, Sham (SG), sham TOT. The intervention was delivered 5 days per week for 4 weeks. Upper measured using Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Action Research Arm Test (ARAT). Activities daily living by modified Barthel Index (MBI). Motor-evoked potentials (MEPs) evaluate cortical excitability. Assessments administered at baseline post-intervention. Additionally, immediate effect detected functional near-infrared spectroscopy (fNIRS) heart rate variability (HRV) before intervention. Results VG showed significant improvements (FMA-UE, ARAT) activities (MBI) compared SG Furthermore, demonstrated higher elicited ipsilesional MEPs shorter latency contralesional M1. VG, FMA-UE significantly associated reduced MEPs. fNIRS revealed increased activation prefrontal cortex sensorimotor contrast SG. However, no between-group differences found HRV. Conclusion combination TOT effectively improves stroke, potentially through modulating bilateral excitability facilitate task-specific recovery.

Language: Английский

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Mechanisms of intermittent theta-burst stimulation attenuating nerve injury after ischemic reperfusion in rats through endoplasmic reticulum stress and ferroptosis

Molecular Biology Reports, Journal Year: 2024, Volume and Issue: 51(1)

Published: March 1, 2024

Abstract Background Repetitive transcranial magnetic stimulation (rTMS) exerts neuroprotective effects early in cerebral ischemia/reperfusion (I/R) injury. Intermittent theta-brust (iTBS), a more time-efficient modality of rTMS, improves the efficiency without at least decreasing efficacy therapy. iTBS elevates cortical excitability, and recent years it has become increasingly common to apply patients post-IS period. However, little is known about mechanisms iTBS. Endoplasmic reticulum stress (ERS), ferroptosis have been shown be involved development I/R We aimed investigate potential regulatory by which attenuates neurological injury after rats. Methods Rats were randomly divided into three groups: sham-operated group, MCAO/R + stimulated with 36 h undergoing middle artery occlusion (MCAO) or sham-operated. The expression ERS, ferroptosis, apoptosis-related markers was subsequently detected western blot assays. also investigated mechanism nerve ischemic reperfusion rats using modified Neurological Severity Score (mNSS) balance beam test measure function. Results performed attenuated levels apoptosis, improved function, including mNSS experiments. It suggested that this mode reduces cost per treatment several times compromising could practical less costly intervention.

Language: Английский

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Techniques, Advantages and Limitations of Neuroimaging: A Systematic Review

Journal of Biomedical and Sustainable Healthcare Applications, Journal Year: 2024, Volume and Issue: unknown, P. 54 - 62

Published: Jan. 5, 2024

Neuroimaging was developed as a non-invasive and objective technique for studying the function structure of normal human brain, utilizing quantitative computational methods. The utilization research in study neurological mental health disorders is experiencing notable increase. While there are post-residency programs offered field Neuro-Radiology, it important to note that neuroimaging not recognized an independent medical specialty. An increasing number studies placing emphasis on matters pertaining rehabilitation. Hence, possessing fundamental understanding prevailing approaches crucial comprehending analyzing this rapidly evolving area. This article provides overview signal source, reviews advantages limitations associated with techniques, presents comprehensive evaluation field. Functional magnetic resonance imaging (fMRI) has materialized prominent tool within realm rehabilitation science due its widespread significance.

Language: Английский

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Excitatory Repetitive Transcranial Magnetic Stimulation Over the Ipsilesional Hemisphere for Upper Limb Motor Function After Stroke: A Systematic Review and Meta-Analysis

Frontiers in Neurology, Journal Year: 2022, Volume and Issue: 13

Published: June 20, 2022

Repetitive transcranial magnetic stimulation (rTMS) is a promising therapy to promote recovery of the upper limb after stroke. According regulation cortical excitability, rTMS can be divided into excitatory and inhibitory rTMS, includes high-frequency (HF-rTMS) or intermittent theta-burst (iTBS). We aimed evaluate effects over ipsilesional hemisphere on motor stroke.Databases PubMed, Embase, ISI Web Science, Cochrane Library were searched for randomized controlled trials published before 31 December 2021. RCTs HF-rTMS iTBS function in patients diagnosed with stroke included. Two researchers independently screened literature, extracted data, assessed quality. The meta-analysis was performed by using Review Manager Version 5.4 software.Fifteen studies 449 participants included this meta-analysis. This found that had significant efficacy (MD = 5.88, 95% CI, 3.32-8.43, P < 0.001), hand strength (SMD 0.53, 0.04-1.01, 0.03), dexterity 0.76, 0.39-1.14, 0.001). Subgroup analyses based different types showed both significantly promoted (iTBS, 0.001; HF-rTMS, 0.001) 0.01; but not 0.07; 0.12). Further subgroup analysis duration illness demonstrated applying during first 3 months (<1 month, 1-3 months, brought improvement longer than (P 0.06). enhanced evoked potential (MEP) amplitude affected 0.82, 0.32-1.33, 0.001).Our study could improve function, strength, Both which dexterity, beneficial only when applied enhance MEP hemisphere. High-quality large-scale future are required confirm our conclusions.www.crd.york.ac.uk/prospero/, identifier: CRD42022312288.

Language: Английский

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Rehabilitation of motor function after stroke: A bibliometric analysis of global research from 2004 to 2022

Frontiers in Aging Neuroscience, Journal Year: 2022, Volume and Issue: 14

Published: Nov. 2, 2022

Background and aims The mortality rate of stroke has been increasing worldwide. Poststroke somatic dysfunctions are common. Motor function rehabilitation patients with such enhances the quality life long primary practice to achieve functional recovery. In this regard, we aimed delineate new trends frontiers in motor literature published from 2004 2022 using a bibliometric software. Methods All documents related were retrieved Web Science Core Collection. Publication output, research categories, countries/institutions, authors/cocited authors, journals/cocited journals, cocited references, keywords assessed VOSviewer v.1.6.15.0 CiteSpace version 5.8. cocitation map was plotted according analysis results intuitively observe hotspots. Results Overall, 3,302 articles 78 countries or regions 564 institutions. Over time, publication outputs increased annually. terms national contribution, United States most papers, followed by China, Japan, South Korea, Canada. Yeungnam University had among all institutions, Emory University, Fudan National Taiwan University. Jang Sung Ho Wolf S.L. productive (56 articles) influential (cited 1,121 times) respectively. “Effect constraint-induced movement therapy on upper extremity 3–9 months after stroke: Extremity Constraint Induced Therapy Evaluation randomized clinical trial” frequently cited reference. Analysis showed that limbs, Fugl–Meyer assessment, electromyography, virtual reality, telerehabilitation, exoskeleton, brain–computer interface development focus areas for topic. Conclusion Publications regarding following likely continuously increase. Research telemedicine, electroacupuncture, interface, robots attracted attention, these topics becoming hotspots present future research.

Language: Английский

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The mechanism and effect of repetitive transcranial magnetic stimulation for post-stroke pain

Frontiers in Molecular Neuroscience, Journal Year: 2023, Volume and Issue: 15

Published: Jan. 6, 2023

Post-stroke pain (PSP) is a common complication after stroke and affects patients' quality of life. Currently, drug therapy non-invasive brain stimulation are treatments for PSP. Given the poor efficacy various side effects, stimulation, such as repetitive transcranial magnetic (rTMS), has been accepted by many patients attracted attention researchers because its painless nature. This article reviews therapeutic effect rTMS on PSP discusses possible mechanisms. In general, good Possible mechanisms analgesia include altering cortical excitability synaptic plasticity, modulating release related neurotransmitters, affecting structural functional connectivity regions involved in processing modulation. At present, studies mechanism treatment lacking, so we hope this review can provide theoretical basis future studies.

Language: Английский

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High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) impacts activities of daily living of patients with post-stroke cognitive impairment: a systematic review and meta-analysis

Neurological Sciences, Journal Year: 2023, Volume and Issue: 44(8), P. 2699 - 2713

Published: April 3, 2023

Language: Английский

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Transcranial magnetic stimulation therapy for central post-stroke pain: systematic review and meta-analysis

Frontiers in Neuroscience, Journal Year: 2024, Volume and Issue: 18

Published: Feb. 14, 2024

Introduction Although rare, central post-stroke pain remains one of the most refractory forms neuropathic pain. It has been reported that repetitive transcranial magnetic stimulation (rTMS) may be effective in these cases Aim The aim this study was to investigate efficacy rTMS patients with (CPSP). Methods We included randomized controlled trials or Controlled Trials published until October 3rd, 2022, which studied effect compared placebo CPSP. studies adult (&gt;18 years) a clinical diagnosis stroke, intervention consisted application treat CSP. Results Nine were qualitative analysis; 6 (4 RCT and 2 non-RCT), 180 participants, quantitative analysis. A significant reduction CPSP found favor sham, large size (SMD: −1.45; 95% CI: −1.87; −1.03; p &lt; 0.001; I2: 58%). Conclusion findings present systematic review meta-analysis suggest there is low quality evidence for effectiveness reducing Systematic registration Identifier (CRD42022365655).

Language: Английский

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Synergistic efficacy of repetitive peripheral magnetic stimulation on central intermittent theta burst stimulation for upper limb function in patients with stroke: a double-blinded, randomized controlled trial

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2024, Volume and Issue: 21(1)

Published: April 8, 2024

Non-invasive techniques such as central intermittent theta burst stimulation (iTBS) and repetitive peripheral magnetic (rPMS) have shown promise in improving motor function for patients with stroke. However, the combined efficacy of rPMS iTBS has not been extensively studied. This randomized controlled trial aimed to investigate synergistic effects

Language: Английский

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