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

Frontiers in Neuroscience, Год журнала: 2023, Номер 17

Опубликована: Июль 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.

Язык: Английский

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Comparative efficacy of different noninvasive brain stimulation protocols on upper-extremity motor function and activities of daily living after stroke: a systematic review and network meta-analysis

Neurological Sciences, Год журнала: 2024, Номер 45(8), С. 3641 - 3681

Опубликована: Март 23, 2024

Язык: 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, Год журнала: 2024, Номер 21(1)

Опубликована: Апрель 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

Язык: Английский

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Repetitive transcranial magnetic stimulation for motor function in stroke: a systematic review and meta-analysis of randomized controlled studies

Systematic Reviews, Год журнала: 2025, Номер 14(1)

Опубликована: Фев. 24, 2025

This study aimed to systematically evaluate the safety and effectiveness of repetitive transcranial magnetic stimulation (rTMS) in treating motor dysfunction stroke patients. A systematic search was conducted five online databases, namely, Medline, EMBASE, Cochrane Central Register Controlled Trials (CENTRAL), CINAHL, SPORTDiscus, from their inception July 29, 2024. Studies meeting predetermined inclusion criteria were included. The data analyzed using RevMan 5.4.1 software Stata 15.0. subgroup analysis based on various disease stages intervention frequencies. overall effects estimated either fixed model or random model, with standardized mean differences (SMDs). level evidence assessed Grading Recommendations, Assessment, Development Evaluation (GRADE) framework. total 70 studies encompassing 2951 survivors results quantitative revealed that application 1 Hz rTMS over contralesional primary cortex (M1) significantly improved function during both early stage (< month) moderate effect size (n = 443, SMD 0.44, 95% CI 0.24 0.63, P < 0.00001, I2 47%, fixed-effect model) recovery period (1–6 months) 233, 0.61, 0.34 0.87, 0.0001, 33%, model). In context activities daily living (ADLs), M1 can lead improvements ADLs among individuals 343, 0.67, 0.44 0.89, 79%, However, support improve chronic phase (> 6 is insufficient. Moderate- high-quality suggests may enhance independence ADL (within effect. Nonetheless, as for efficacy 3, 5, 10, 20 treatment after stroke, it needs be further determined. It important interpret these findings caution clinical practice due small sample sizes low quality reviewed. INPLASY, Registration number INPLASY202360042. DOI https://doi.org/10.37766/inplasy2023.6.0042 .

Язык: Английский

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Effects of intermittent theta burst stimulation on upper limb motor recovery in early stroke patients: an fNIRS study

Frontiers in Neurology, Год журнала: 2025, Номер 16

Опубликована: Фев. 26, 2025

To explore the recovery of upper limb motor function and changes in cortical functional connectivity patients with early subcortical small infarcts accompanied by severe dysfunction (PESSUM) after intermittent theta burst stimulation (iTBS) via near-infrared spectroscopy (fNIRS) to related mechanisms. We enrolled 56 ischemic stroke FMA-UE ≤28 randomly assigned them receive either genuine (TG, n = 29) or sham (CG, 23) iTBS plus standard rehabilitation over 8 days. fNIRS was used monitor cerebral HbO, HbD, HbT concentrations, RSFC were analyzed. The MBI scores evaluate daily activities. Intergroup comparisons conducted using independent samples t tests, whereas intragroup performed paired tests Mann-Whitney U tests. trend analyzed repeated-measures Analysis Variance (ANOVA). Both groups showed significant improvements postintervention (p < 0.001). TG had higher than CG 0.005). revealed accelerated cyclical activity TG. significantly improved living ability patients, supporting a role for promoting neural repair accelerating cycles. This study provides evidence that is an effective strategy poststroke. https://www.chictr.org.cn/showproj.html?proj=169674, ChiCTR2200060955.

Язык: Английский

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Effects of Passive Movement on Motor Function and Disability in Patients with Stroke: A Systematic Review and Meta-Analysis

Journal of Functional Morphology and Kinesiology, Год журнала: 2025, Номер 10(2), С. 117 - 117

Опубликована: Март 31, 2025

Background: Severe impairment in motor function following a stroke can pose significant challenge during rehabilitation since the patients are unable to carry out active forms of rehabilitation, such as task-specific training. Thus, case, passive movement be utilized. The aim this systematic review and meta-analysis is determine from literature evidence on effects compared with control recovery outcomes post stroke. Method: Four databases, PubMED, Embase, Web Science (WoS), CENTRAL, were searched. Data study participants’ characteristics, mean age, time stroke, protocol experimental interventions, scores assessed intervention at follow-up, number participants both groups extracted. Result: studies (n = 166), two having moderate quality high methodological quality, included study. test for overall showed that superior improving (SMD 0.82, 95% CI 0.40 −1.24, p 0.0002) intervention. However, results individual domains group only 0.70, 0.21 1.18, 0.005) disability 0.81, 0.32 1.31, 0.001). Conclusions: Evidence seems low. Therefore, clinical decision its application requires reflection, further randomized controlled trials need carried evidence.

Язык: Английский

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The impact of the number of sessions and stimulation parameters on repetitive transcranial magnetic stimulation efficacy for post-stroke upper extremity recovery: A systematic review and meta-analysis

Clinical Rehabilitation, Год журнала: 2025, Номер unknown

Опубликована: Апрель 13, 2025

Objective To identify the optimal number of sessions and parameters repetitive transcranial magnetic stimulation frequency, intensity, pulses per session/treatment that promotes a greater effect on post-stroke upper extremity function. Data sources MEDLINE (PubMed), Cumulative Index to Nursing Allied Health Literature, Physiotherapy Evidence Database, Latin American Caribbean Science Scientific Electronic Library Online, Scopus up November 2024. Review methods We conducted meta-analysis randomized controlled trials combined with other therapies for function, assessed risk-of-bias using Database scale, calculated standard mean differences (SMD) 95% confidence intervals (CI), determined parameter cutoff points receiver operating characteristic curve. Results Thirty-five clinical involving 897 patients were included. Compared control groups, improved motor function higher size for: ≥ 15 (SMD 0.72 CI, 0.37 1.08; p < 0.0001]), > 1 Hz frequencies (0.98 [95% 0.48 1.48; = 0001]), intensities <100% resting threshold 0.52 0.29 0.75; 0.00001]), 1000 session 0.61 0.40 0.82; ≥12,000 treatment 0.64 0.36 0.93; 0.0001]). Conclusion enhance protocol involves at least sessions, above Hz, below 100% threshold, session, 12,000 treatment.

Язык: Английский

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Clinical efficacy observation of repetitive magnetic stimulation for treating upper limb spasticity after stroke

Scientific Reports, Год журнала: 2025, Номер 15(1)

Опубликована: Май 22, 2025

To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) for managing upper limb muscular spasticity after stroke, and to examine its therapeutic effects on motor function in limb. A total 110 post-stroke patients with were randomly assigned experimental or control group. The group received rTMS conjunction conventional rehabilitation therapy. affected side head daily treatment 20 min each at Erb's point point, totaling 15 sessions over six days per week. frequencies 10 Hz (high frequency, M1 region) 1 (low point), an intensity 120% threshold. sham alongside Assessments including Modified Ashworth Scale (MAS) Fugl-Meyer Assessment Upper Extremity (FM-UE), also conducted before initiation rounds rTMS. Post hoc subgroup analyses using independent-sample t-tests FM-UE scores Mann-Whitney U tests MAS assess heterogeneity responses by stroke type (cerebral infarction vs. intracerebral hemorrhage). Among these patients, 25 excluded from study various reasons. Hence, 53 included 32 Following rTMS, exhibited a reductions score (P = 0.004). increased significantly both groups (both P < 0.05), significant improvement observed 0.05). Subgroup revealed no differences outcomes between types, likely due limited sample size hemorrhage participants (experimental group: n 8; 16). effectively alleviates enhances modulating cortical spinal nerve excitability.

Язык: Английский

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Network Meta-Analysis of 4 Rehabilitation Methods With rTMS on Upper Limb Function and Daily Activities in Patients With Stroke

Stroke, Год журнала: 2025, Номер unknown

Опубликована: Май 30, 2025

BACKGROUND: Stroke is one of the leading causes disability and death worldwide, often to physical paralysis cognitive dysfunction, seriously affecting patients’ quality life, increasing economic burden. Repetitive transcranial magnetic stimulation (rTMS), a noninvasive brain technique, has been used in stroke rehabilitation, but difference efficacy among rehabilitation methods combined with rTMS unclear. In this study, we compared effects 4 methods, namely, clinical routine therapy, smart behavioral Chinese traditional therapy (CTRT) on upper limb function activities daily living patients through reticulated meta-analysis, which provided basis for optimization strategies. METHODS: Six databases, PubMed, Embase, Web Science, Cochrane, EBSCO, China National Knowledge Infrastructure, were systematically searched, 24 randomized controlled trials total 868 finally included. The primary outcome indicators Fugl-Meyer assessment (Barthel index, modified Barthel functional independence measure included). Network meta-analysis was performed using Stata 17.0 assess relative effect each intervention examine consistency direct indirect evidence. RESULTS: involving CTRT had most significant improvement (standardized mean [SMD], 1.23 [95% CI, 0.95–1.52]; P <0.0001), effective improving (SMD, 1.74 1.31–2.18]; <0.0001). Clinical that improved action research arm test 3.19 1.70–4.69]; <0.0001) combination box block test, none them exerted ( >0.05). wolf motor 0.78 0.39–1.16]; Ashworth scale −0.67 −0.99 −0.36]; grip strength 1.21 0.42–2.00]; <0.01). CONCLUSIONS: This shows varied body functions structures along participation stroke. Behavioral enhances hand strength, improve reduce scale, while boosts living. These results highlight need personalized strategies based individual patient needs optimize outcomes. Future should explore mechanisms underlying these differences.

Язык: Английский

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Acupuncture combined with repeated transcranial magnetic stimulation for upper limb motor function after stroke: A systematic review and meta-analysis

Neurorehabilitation, Год журнала: 2023, Номер 53(4), С. 423 - 438

Опубликована: Дек. 22, 2023

BACKGROUND: Upper limb motor dysfunction after stroke is an important factor affecting patients’ function and daily life. Acupuncture repetitive transcranial magnetic stimulation are effective methods for rehabilitation. However, a systematic comprehensive overview of the combined efficacy two lacking. OBJECTIVE: Through review meta-analysis randomized controlled trials, this study aimed to assess effectiveness acupuncture with on upper extremity in post-stroke patients. METHODS: The relevant trials treatment disorders were searched PubMed, Embase, Cochrane Library, Web Science CNKI, VIP, Wanfang, CBM databases. After screening clinical that met inclusion criteria, data extraction was conducted independently by investigators. Meta-analysis performed using RevMan 5.4 software. RESULTS: screening, 18 articles included, total 1083 subjects. results showed combination therapy could effectively improve (MD = 7.77, 95%CI [6.32, 9.22], P < 0.05), ability living 8.53, [6.28, 10.79], hemiplegic shoulder pain – 1.72, [– 2.26, 1.18], 0.05). Meanwhile, neurophysiological indexes, significantly shorten latency evoked potential central conduction time 1.42, 2.14, 0.71], 0.05); 0.47, 0.66, 0.29], also increase amplitude (SMD 0.71, [0.28, 1.14], CONCLUSION: According meta-analysis, we can conclude repeated

Язык: Английский

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