Cortical stimulation did not augment the gains from a late rehabilitation program. The effect size anticipated by the authors was overestimated. These results can improve the design of future work on therapeutic uses of TMS.

No abstract

The physiotherapy protocol standardized intensity of treatment by grading exercise and task-related practice according to the person's residual ability, rather than simply standardizing treatment times. It was feasible and well tolerated in this group.

There is considerable inter-study and inter-individual variation in the scalp location of parietal sites where transcranial magnetic stimulation (TMS) may modulate visuospatial behaviours (see Ryan, Bonilha, & Jackson 2006); and no clear consensus on methods for identifying such sites. Here we introduce a novel TMS "hunting paradigm" that allows rapid, reliable identification of a site over right anterior intraparietal sulcus (IPS), where short trains (at 10 Hz for 0.5s) of TMS disrupt performance of a task in which subjects judge the presence or absence of a small peripheral gap (at 14 degrees eccentricity), on one or other (known) side of an extended (29 degrees) horizontal line centred on fixation. Signal detection analysis confirmed that TMS at this site reduced sensitivity (d') for gap targets in the left visual hemifield. A further experiment showed that the same right-parietal TMS increased sensitivity instead for gaps in the right hemifield. Comparing TMS across a grid of scalp locations around the identified 'hotspot' confirmed the spatial specificity. Assessment of the TMS intensity required to produce the phenomena found this was linearly related to individuals' resting motor TMS threshold over hand M1. Our approach provides a systematic new way to identify an effective site and intensity in individuals, at which TMS over right parietal cortex reliably changes visuospatial sensitivity.