Evaluation of fMRI activation in hemiparetic stroke patients after rehabilitation with low-frequency repetitive transcranial magnetic stimulation and intensive occupational therapy

Evaluation of fMRI activation in post-stroke patients with movement disorders after repetitive transcranial magnetic stimulation: a scoping review

“…The thalamus served as a relay station for the sensory-motor route, sending relevant sensory and motor information to the cortex ( 73 ). Activations of the corpus callosum after rTMS in the included study ( 35 ) are in general consistent with previous research that indicated similar change in the affected hand movements after intervention ( 74 ). Another study demonstrated that changes in the structure of the corpus callosum are related to transcallosal inhibition and upper limb dysfunction in chronic stroke ( 75 ).…”

“…According to Grefkes et al ( 36 ), 1-Hz rTMS has suppressive effects on ipsilesional M1 and facilitates more efficient motor processing in the contralesional hemisphere, as shown by the improved coupling of SMA and M1. Wanni et al ( 35 ) show significant activations were seen in the ipsilesional PMA, M1, and thalamic-cortical regions with the paretic hand movements after rTMS. However, significant activations in the contralesional primary somatosensory cortex (S1), superior parietal cortex, and bilateral cerebellum with unaffected hand movements after the intervention were observed.…”

“…The cerebellum maintains many neural connections with the motor cortex, which controls motor skills such as motor coordination, fine motor, and motor learning ( 72 ). Moreover, the fMRI findings also found activations in bilateral thalamocortical circuits are associated with affected hand motions after rTMS ( 35 ). The thalamus served as a relay station for the sensory-motor route, sending relevant sensory and motor information to the cortex ( 73 ).…”

“…In both cases, rTMS can correct the maladaptive brain plasticity induced by stroke or enhance adaptive brain plasticity. Based on the fMRI findings, significant clusters in the bilateral cerebellum were observed during the unaffected hand movements after rTMS, suggesting the cerebellum play a role in stroke recovery ( 35 ). The cerebellum maintains many neural connections with the motor cortex, which controls motor skills such as motor coordination, fine motor, and motor learning ( 72 ).…”

Transcranial magnetic stimulation therapy for central post-stroke pain: systematic review and meta-analysis

“…Moreover, ≤1 Hz frequencies (low-frequency rTMS) produce the opposite effect via long-term depression ( Chen et al, 1997 ). These neuroplastic changes could induce reorganization of neural networks in the motor cortex, supplementary motor area, premotor area, cerebellum, thalamus and corpus callosum ( Tosun et al, 2017 ; Guo et al, 2021 ; Wanni Arachchige et al, 2023 ). As well as reversal of functional connectivity changes ( Grefkes et al, 2010 ; Guo et al, 2021 ; Juan et al, 2022 ) that occur after the stroke ( Li et al, 2017 ; Vecchio et al, 2019 ).…”