Cargando…

Repetitive Transcranial Magnetic Stimulation on the Affected Hemisphere Enhances Hand Functional Recovery in Subacute Adult Stroke Patients: A Randomized Trial

Objectives: Either motor training or repetitive transcranial magnetic stimulation (rTMS) could modulate the neural plasticity after stroke. Therefore, synchronizing the two interventions may optimize the efficiency of recovery. In the present study, we aim to investigate the effect of rTMS along wit...

Descripción completa

Detalles Bibliográficos
Autores principales: Yang, Yawen, Pan, Huijuan, Pan, Wenxiu, Liu, Yang, Song, Xiaohui, Niu, Chuanxin M., Feng, Wuwei, Wang, Jixian, Xie, Qing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8171119/
https://www.ncbi.nlm.nih.gov/pubmed/34093164
http://dx.doi.org/10.3389/fnagi.2021.636184
_version_ 1783702369726365696
author Yang, Yawen
Pan, Huijuan
Pan, Wenxiu
Liu, Yang
Song, Xiaohui
Niu, Chuanxin M.
Feng, Wuwei
Wang, Jixian
Xie, Qing
author_facet Yang, Yawen
Pan, Huijuan
Pan, Wenxiu
Liu, Yang
Song, Xiaohui
Niu, Chuanxin M.
Feng, Wuwei
Wang, Jixian
Xie, Qing
author_sort Yang, Yawen
collection PubMed
description Objectives: Either motor training or repetitive transcranial magnetic stimulation (rTMS) could modulate the neural plasticity after stroke. Therefore, synchronizing the two interventions may optimize the efficiency of recovery. In the present study, we aim to investigate the effect of rTMS along with hand grip training on the neurobehavioral and hand functional recovery in one cohort of subacute stroke patients. Methods: Thirty-nine stroke patients were enrolled in a single-center, single-blinded, randomized clinical trial. We tested different intervention effects of rTMS and hand grip training (group A), rTMS alone (group B), and hand grip training alone (group C). For the rTMS-treated groups, patients received 10 consecutive sessions of 5-Hz stimulation over the affected hemisphere with 750 pulses. Jebsen–Taylor Hand Function Test (JTHFT), Fugl-Meyer assessment of upper extremity (FMA-UE), grip strength, modified Barthel index (mBI), and ipsilesional motor evoked potential (iMEP) latency were assessed and compared across the groups. Results: We found that only rTMS along with hand grip training group all improved in JTHFT, FMA-UE, grip strength, and mBI (p ≤ 0.01) compared with the baseline among the three groups. Furthermore, this study demonstrated that rTMS plus hand grip training had much better results in improvement of neurobehavioral outcomes compared to the rTMS alone- and hand grip training alone-treated patients (p < 0.05). However, no significant differences were detected in neurophysiologic outcome between intra-groups and inter-groups (p > 0.05). Conclusion: These proof-of-concept results suggested that rTMS alone with hand grip training was a unique approach to promote hand functional recovery in stroke patients. It provided important information to design a large-scale multi-center clinical trial to further demonstrate the efficiency of the combination of central and peripheral stimulation. Clinical Trial Registration: http://www.chictr.org.cn (#ChiCTR1900023443).
format Online
Article
Text
id pubmed-8171119
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-81711192021-06-03 Repetitive Transcranial Magnetic Stimulation on the Affected Hemisphere Enhances Hand Functional Recovery in Subacute Adult Stroke Patients: A Randomized Trial Yang, Yawen Pan, Huijuan Pan, Wenxiu Liu, Yang Song, Xiaohui Niu, Chuanxin M. Feng, Wuwei Wang, Jixian Xie, Qing Front Aging Neurosci Aging Neuroscience Objectives: Either motor training or repetitive transcranial magnetic stimulation (rTMS) could modulate the neural plasticity after stroke. Therefore, synchronizing the two interventions may optimize the efficiency of recovery. In the present study, we aim to investigate the effect of rTMS along with hand grip training on the neurobehavioral and hand functional recovery in one cohort of subacute stroke patients. Methods: Thirty-nine stroke patients were enrolled in a single-center, single-blinded, randomized clinical trial. We tested different intervention effects of rTMS and hand grip training (group A), rTMS alone (group B), and hand grip training alone (group C). For the rTMS-treated groups, patients received 10 consecutive sessions of 5-Hz stimulation over the affected hemisphere with 750 pulses. Jebsen–Taylor Hand Function Test (JTHFT), Fugl-Meyer assessment of upper extremity (FMA-UE), grip strength, modified Barthel index (mBI), and ipsilesional motor evoked potential (iMEP) latency were assessed and compared across the groups. Results: We found that only rTMS along with hand grip training group all improved in JTHFT, FMA-UE, grip strength, and mBI (p ≤ 0.01) compared with the baseline among the three groups. Furthermore, this study demonstrated that rTMS plus hand grip training had much better results in improvement of neurobehavioral outcomes compared to the rTMS alone- and hand grip training alone-treated patients (p < 0.05). However, no significant differences were detected in neurophysiologic outcome between intra-groups and inter-groups (p > 0.05). Conclusion: These proof-of-concept results suggested that rTMS alone with hand grip training was a unique approach to promote hand functional recovery in stroke patients. It provided important information to design a large-scale multi-center clinical trial to further demonstrate the efficiency of the combination of central and peripheral stimulation. Clinical Trial Registration: http://www.chictr.org.cn (#ChiCTR1900023443). Frontiers Media S.A. 2021-05-19 /pmc/articles/PMC8171119/ /pubmed/34093164 http://dx.doi.org/10.3389/fnagi.2021.636184 Text en Copyright © 2021 Yang, Pan, Pan, Liu, Song, Niu, Feng, Wang and Xie. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Aging Neuroscience
Yang, Yawen
Pan, Huijuan
Pan, Wenxiu
Liu, Yang
Song, Xiaohui
Niu, Chuanxin M.
Feng, Wuwei
Wang, Jixian
Xie, Qing
Repetitive Transcranial Magnetic Stimulation on the Affected Hemisphere Enhances Hand Functional Recovery in Subacute Adult Stroke Patients: A Randomized Trial
title Repetitive Transcranial Magnetic Stimulation on the Affected Hemisphere Enhances Hand Functional Recovery in Subacute Adult Stroke Patients: A Randomized Trial
title_full Repetitive Transcranial Magnetic Stimulation on the Affected Hemisphere Enhances Hand Functional Recovery in Subacute Adult Stroke Patients: A Randomized Trial
title_fullStr Repetitive Transcranial Magnetic Stimulation on the Affected Hemisphere Enhances Hand Functional Recovery in Subacute Adult Stroke Patients: A Randomized Trial
title_full_unstemmed Repetitive Transcranial Magnetic Stimulation on the Affected Hemisphere Enhances Hand Functional Recovery in Subacute Adult Stroke Patients: A Randomized Trial
title_short Repetitive Transcranial Magnetic Stimulation on the Affected Hemisphere Enhances Hand Functional Recovery in Subacute Adult Stroke Patients: A Randomized Trial
title_sort repetitive transcranial magnetic stimulation on the affected hemisphere enhances hand functional recovery in subacute adult stroke patients: a randomized trial
topic Aging Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8171119/
https://www.ncbi.nlm.nih.gov/pubmed/34093164
http://dx.doi.org/10.3389/fnagi.2021.636184
work_keys_str_mv AT yangyawen repetitivetranscranialmagneticstimulationontheaffectedhemisphereenhanceshandfunctionalrecoveryinsubacuteadultstrokepatientsarandomizedtrial
AT panhuijuan repetitivetranscranialmagneticstimulationontheaffectedhemisphereenhanceshandfunctionalrecoveryinsubacuteadultstrokepatientsarandomizedtrial
AT panwenxiu repetitivetranscranialmagneticstimulationontheaffectedhemisphereenhanceshandfunctionalrecoveryinsubacuteadultstrokepatientsarandomizedtrial
AT liuyang repetitivetranscranialmagneticstimulationontheaffectedhemisphereenhanceshandfunctionalrecoveryinsubacuteadultstrokepatientsarandomizedtrial
AT songxiaohui repetitivetranscranialmagneticstimulationontheaffectedhemisphereenhanceshandfunctionalrecoveryinsubacuteadultstrokepatientsarandomizedtrial
AT niuchuanxinm repetitivetranscranialmagneticstimulationontheaffectedhemisphereenhanceshandfunctionalrecoveryinsubacuteadultstrokepatientsarandomizedtrial
AT fengwuwei repetitivetranscranialmagneticstimulationontheaffectedhemisphereenhanceshandfunctionalrecoveryinsubacuteadultstrokepatientsarandomizedtrial
AT wangjixian repetitivetranscranialmagneticstimulationontheaffectedhemisphereenhanceshandfunctionalrecoveryinsubacuteadultstrokepatientsarandomizedtrial
AT xieqing repetitivetranscranialmagneticstimulationontheaffectedhemisphereenhanceshandfunctionalrecoveryinsubacuteadultstrokepatientsarandomizedtrial