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Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients

BACKGROUND: Stroke is one of the leading causes of mortality and morbidity in Malaysia. Repetitive transcranial magnetic stimulation (rTMS) is one of the new non-invasive modality to enhance the motor recovery in stroke patients. OBJECTIVES: This pilot study compared the motor evoked potential (MEP)...

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Autores principales: Hanafi, Muhammad Hafiz, Kassim, Nur Karyatee, Ibrahim, Al Hafiz, Adnan, Munirah Mohd, Ahmad, Wan Muhamad Amir W, Idris, Zamzuri, Latif, Lydia Abdul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Penerbit Universiti Sains Malaysia 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422591/
https://www.ncbi.nlm.nih.gov/pubmed/30918461
http://dx.doi.org/10.21315/mjms2018.25.2.12
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author Hanafi, Muhammad Hafiz
Kassim, Nur Karyatee
Ibrahim, Al Hafiz
Adnan, Munirah Mohd
Ahmad, Wan Muhamad Amir W
Idris, Zamzuri
Latif, Lydia Abdul
author_facet Hanafi, Muhammad Hafiz
Kassim, Nur Karyatee
Ibrahim, Al Hafiz
Adnan, Munirah Mohd
Ahmad, Wan Muhamad Amir W
Idris, Zamzuri
Latif, Lydia Abdul
author_sort Hanafi, Muhammad Hafiz
collection PubMed
description BACKGROUND: Stroke is one of the leading causes of mortality and morbidity in Malaysia. Repetitive transcranial magnetic stimulation (rTMS) is one of the new non-invasive modality to enhance the motor recovery in stroke patients. OBJECTIVES: This pilot study compared the motor evoked potential (MEP) changes using different settings of rTMS in the post-ischemic stroke patient. The goal of the study is to identify effect sizes for a further trial and evaluate safety aspects. METHODS: Eight post-stroke patients with upper limb hemiparesis for at least six months duration were studied in a tertiary hospital in Northeast Malaysia. Quasi experimental design was applied and the participants were randomised into two groups using software generated random numbers. One of the two settings: i) inhibitory setting, or ii) facilitatory setting have been applied randomly during the first meeting. The motor evoked potential (MEP) were recorded before and after application of the rTMS setting. A week later, a similar procedure will be repeated but using different setting than the first intervention. Each patient will serve as their own control. Repeated measures ANOVA test was applied to determine the effect sizes for both intervention through the options of partial eta-squared (η(2)(p)). RESULT: The study observed large effect sizes (η(2)(p) > 0.14) for both rTMS settings in the lesion and non-lesion sides. For safety aspects, no minor or major side effects associated with the rTMS was reported by the participants. CONCLUSIONS: The partial eta square of MEP value for both rTMS settings (fascilitatory and inhibitory) in both lesion and non-lesion sides represents large effect sizes. We recommend further trial to increase number of sample in order to study the effectiveness of both settings in ischemic stroke patient. Our preliminary data showed both settings may improve the MEP of the upper extremity in the ischemic stroke patient. No significant improvement noted when comparing both settings.
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spelling pubmed-64225912019-03-27 Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients Hanafi, Muhammad Hafiz Kassim, Nur Karyatee Ibrahim, Al Hafiz Adnan, Munirah Mohd Ahmad, Wan Muhamad Amir W Idris, Zamzuri Latif, Lydia Abdul Malays J Med Sci Original Article BACKGROUND: Stroke is one of the leading causes of mortality and morbidity in Malaysia. Repetitive transcranial magnetic stimulation (rTMS) is one of the new non-invasive modality to enhance the motor recovery in stroke patients. OBJECTIVES: This pilot study compared the motor evoked potential (MEP) changes using different settings of rTMS in the post-ischemic stroke patient. The goal of the study is to identify effect sizes for a further trial and evaluate safety aspects. METHODS: Eight post-stroke patients with upper limb hemiparesis for at least six months duration were studied in a tertiary hospital in Northeast Malaysia. Quasi experimental design was applied and the participants were randomised into two groups using software generated random numbers. One of the two settings: i) inhibitory setting, or ii) facilitatory setting have been applied randomly during the first meeting. The motor evoked potential (MEP) were recorded before and after application of the rTMS setting. A week later, a similar procedure will be repeated but using different setting than the first intervention. Each patient will serve as their own control. Repeated measures ANOVA test was applied to determine the effect sizes for both intervention through the options of partial eta-squared (η(2)(p)). RESULT: The study observed large effect sizes (η(2)(p) > 0.14) for both rTMS settings in the lesion and non-lesion sides. For safety aspects, no minor or major side effects associated with the rTMS was reported by the participants. CONCLUSIONS: The partial eta square of MEP value for both rTMS settings (fascilitatory and inhibitory) in both lesion and non-lesion sides represents large effect sizes. We recommend further trial to increase number of sample in order to study the effectiveness of both settings in ischemic stroke patient. Our preliminary data showed both settings may improve the MEP of the upper extremity in the ischemic stroke patient. No significant improvement noted when comparing both settings. Penerbit Universiti Sains Malaysia 2018-03 2018-04-27 /pmc/articles/PMC6422591/ /pubmed/30918461 http://dx.doi.org/10.21315/mjms2018.25.2.12 Text en © Penerbit Universiti Sains Malaysia, 2018 This work is licensed under the terms of the Creative Commons Attribution (CC BY) (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Article
Hanafi, Muhammad Hafiz
Kassim, Nur Karyatee
Ibrahim, Al Hafiz
Adnan, Munirah Mohd
Ahmad, Wan Muhamad Amir W
Idris, Zamzuri
Latif, Lydia Abdul
Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients
title Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients
title_full Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients
title_fullStr Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients
title_full_unstemmed Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients
title_short Cortical Modulation After Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Similar Ischemic Stroke Patients
title_sort cortical modulation after two different repetitive transcranial magnetic stimulation protocols in similar ischemic stroke patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422591/
https://www.ncbi.nlm.nih.gov/pubmed/30918461
http://dx.doi.org/10.21315/mjms2018.25.2.12
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