Comparison of the Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation with That of Theta Burst Stimulation on Upper Limb Motor Function in Poststroke Patients

BACKGROUND: The purpose of this study was to evaluate the difference between the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) and that of continuous theta burst stimulation (cTBS), when each is combined with intensive occupational therapy (OT), in poststroke patients with upper limb hemiparesis. MATERIALS AND METHODS: The study subjects were 103 poststroke patients with upper limb hemiparesis, who were divided into two groups: the LF-rTMS group (n = 71) and the cTBS group (three pulse bursts at 50 Hz) (n = 32). Each subject received 12 sessions of repetitive transcranial magnetic stimulation of 2,400 pulses applied to the nonlesional hemisphere and 240-min intensive OT (two 60-min one-to-one training sessions and two 60-min self-training exercises) daily for 15 days. Motor function was evaluated using the Fugl-Meyer Assessment (FMA) and the performance time of the Wolf motor function test (WMFT) was determined on the days of admission and discharge. RESULTS: Both groups showed a significant increase in the FMA score and a short log performance time of the WMFT (p < 0.001), but the increase in the FMA score was higher in the LF-rTMS group than the cTBS group (p < 0.05). CONCLUSION: We recommend the use of 2400 pulses of LF-rTMS/OT for 2 weeks as treatment for hemiparetic patients.