Effect of Repetitive Transcranial Magnetic Stimulation Pulses on Muscle Spasticity of Cerebral Palsy Children

Rajak, Bablu Lal; Gupta, Meena; Bhatia, Dinesh; Mukherjee, Arun

doi:10.4172/2329-9096.1000465

Cited by 2 publications

(5 citation statements)

References 27 publications

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“…It has been previously stated and determined in our studies that rTMS was more effective than PT or standard therapy alone in control group. [16171819] These interesting results can lead to better acceptability of a new treatment regime for CP that is required for inducing faster gain in motor activity and in achieving developmental milestone since these children show delayed motor and cognitive growth patterns.…”

Section: Discussionmentioning

confidence: 99%

“…The rTMS frequency of 10 Hz and pulse train of 2500 was kept constant after establishing their stimulating effect published in our previous communicated studies. [1619] Participants in S-20, S-30, and S-40 were provided 20, 30, and 40 sessions of rTMS therapy, respectively. Each rTMS session was of 25-min duration and was administered once daily for 5 days a week for 4 weeks to S-20 group, for 6 weeks to S-30 group, and for 8 weeks to S-40 group.…”

Section: Methodsmentioning

confidence: 99%

“…[161718] Moreover, when variation in pulse train was studied, keeping rTMS frequency of 10 Hz constant, it was found that pulse of 2500 leads to decrease in muscle spasticity as compared to 1500 and 2000 pulses again not compromising on patient safety due to high dosages involved. [19] Now, in the current study, for the first time, we report the effect of rTMS on motor functions and muscle spasticity of spastic CP children by varying the number of therapy sessions to be administered. We found that by increasing the number of rTMS therapy sessions, there was remarkable improvement in functional gain of the motor abilities in CP children which might be due to the increase neural processing that enhanced cortical excitability.…”

Section: Introductionmentioning

confidence: 99%

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Increasing number of therapy sessions of repetitive transcranial magnetic stimulation improves motor development by reducing muscle spasticity in cerebral palsy children

Rajak¹,

Gupta²,

Bhatia³

et al. 2019

Ann Indian Acad Neurol

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Background: Repetitive TMS (rTMS), a non-invasive neuro-stimulation tool based on the principle of electromagnetic induction is recently being employed both for investigational and interventional purposes. The stimulating effect of rTMS on motor cortex areas of the brain leads to increased motor activity and decreased muscle tone in spastic cerebral palsy (CP) patients. Objective: This modulatory effect of rTMS is used in this study to evaluate its effect on motor function and spasticity by increasing the number of therapy session and keeping frequency of 10Hz and pulse train of 2500 constant. Methods: Total thirty spastic CP patients participated in this study after written informed consent from their parents/guardians. The participants were equally divided into three groups, namely, S-20, S-30 and S-40 depending on the number of therapy sessions. The mean age±SD of participants in different groups were 8.9±3.6, 9.5±2.9 and 8.4±3.5 in S-20, S-30 and S-40 respectively. Participants in S-20, S-30 and S-40 were provided 20, 30 and 40 sessions of rTMS therapy respectively followed by physical therapy of 30 minutes daily. Each rTMS session was of 25 minutes duration and was administered once daily for 5 days a week. Prior to start and after completion of the therapy, pre and post assessment of gross motor function measure (GMFM) for motor function and modified Ashworth scale (MAS) for muscle spasticity was performed on all the participants. Outcomes: The result of pre-versus-post GMFM score showed that 4.27%, 3.12% and 2.36% motor gain was obtained after 40, 30 and 20 sessions of therapy respectively. In addition, significant reduction in spasticity in both upper and limb muscles was also observed in all the three groups.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increasing number of therapy sessions of repetitive transcranial magnetic stimulation improves motor development by reducing muscle spasticity in cerebral palsy children

Rajak¹,

Gupta²,

Bhatia³

et al. 2019

Ann Indian Acad Neurol

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“…Due to repetitive nature of the magnetic pulse restorative neuronal activity in brain is affected by altering pre-restorative dynamics of the neuronal firing in restorative area of the brain (Ridding MC, 2007). In recent literature, it is shown that the stimulation using this technique can excite motor neuron that provides motor function in animals such as rat (Adkins-Muir DL, 2003), (Plautz EJ, 2003) and in humans(M., 2000) (Sénéchal C, 2007) (Rajak BL G. M., 2017). Kirton validated use of TMS on neural disorders like stroke and CP that excite motor function after motor cortex stimulation (A, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Some results showed that rTMS therapy (Meena Gupta, 2016) in spastic CP improves motor activity (Gupta M, 2016). Effect of this therapy was also checked by quality of upper extremity skill test (QUEST) in CP kids (Rajak BL G. M., 2017).…”

Section: Introductionmentioning

confidence: 99%

Comparison of EEG Signals of Cerebral Palsy Patients after Standard and rTMS Therapy

Tiwari¹,

Singh²,

Bhatia³

2018

Arch Neurol Neuro Disord

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Objectives: Study the effect of repetitive TMS at different frequencies and compare them with standard therapy (physical therapy or PT).Methods: In this paper results are observed on the basis of sensorimotor response (SMR) and Beta wave values generated in the frontal lobe collected from 36 CP patients, out of which 12 patients were provided PT only, 5Hz rTMS + PT in other 12 patients and 10Hz rTMS + PT in the remaining 12 patients was provided for 20 days duration. The patients who were treated with PT as well as rTMS were administered a 30 minutes session comprising of 10 minutes rTMS and 20 minutes of PT. Results: The results showed improved SMR and Beta median in case of patients administered 10 Hz rTMS in comparison to those administered 5 Hz and standard therapyConclusions: Transcranial Magnetic Stimulator has been used for providing rehabilitation to CP and other neuro disorders. It provided at various frequencies for improving patient's condition. In this study it is proved that repetitive TMS at 10 Hz frequency is beneficial for muscle spasticity and motor control because it improves frontal lobe SMR which is responsible for motor control and beta which is for muscle spasticity.Significance: Cerebral palsy is a non-progressive motor disorder. It has been described as continuous but changing disorder of posture and movement and its symptom shows in early years of life. This disorder mostly affects children who suffers by perception disturbances, sensation, musculoskeletal problem and epilepsy. These problems are caused by disturbance in cortical or subcortical section of brain. To control these abnormal activities, certain therapies are employed to treat these children. Previously, physical therapy (PT) training was the only way which was employed to provide muscle relaxation therapy to the patient. However, nowadays, PT is accompanied with a new non-invasive Neurostimulation method which is known as repetitive transcranial magnetic stimulation (rTMS). This therapy has been found to help in decreasing muscle tone in CP patients.

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Effect of Repetitive Transcranial Magnetic Stimulation Pulses on Muscle Spasticity of Cerebral Palsy Children

Cited by 2 publications

References 27 publications

Increasing number of therapy sessions of repetitive transcranial magnetic stimulation improves motor development by reducing muscle spasticity in cerebral palsy children

Increasing number of therapy sessions of repetitive transcranial magnetic stimulation improves motor development by reducing muscle spasticity in cerebral palsy children

Comparison of EEG Signals of Cerebral Palsy Patients after Standard and rTMS Therapy

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