Exploring Theta Burst Stimulation as an intervention to improve motor recovery in chronic stroke

Talelli, P; Greenwood, Richard; Rothwell, John C.

doi:10.1016/j.clinph.2006.10.014

Cited by 240 publications

(228 citation statements)

References 35 publications

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“…For example, cTBS of contralesional M1 has been used to try to suppress its excitability and improve paretic hand function. To date, outcomes have been mixed (Ackerley et al 2010;Bolognini et al 2009;Di Lazzaro et al 2008;Nowak et al 2009;Talelli et al 2007). It is worth keeping in mind that cTBS applied to the contralesional M1 after stroke may have unintended deleterious consequences for control of proximal muscles of the paretic limb.…”

Section: Discussionmentioning

confidence: 99%

Theta Burst Stimulation of Human Primary Motor Cortex Degrades Selective Muscle Activation in the Ipsilateral Arm

Bradnam

Stinear

Byblow³

2010

Journal of Neurophysiology

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Bradnam LV, Stinear CM, Byblow WD. Theta burst stimulation of human primary motor cortex degrades selective muscle activation in the ipsilateral arm. J Neurophysiol 104: 2594 -2602, 2010. First published September 15, 2010 doi:10.1152/jn.00365.2010. This study investigated whether repetitive transcranial magnetic stimulation (TMS) delivered as continuous theta burst stimulation (cTBS) to left M1 degraded selective muscle activation in the contralateral and ipsilateral upper limb in healthy participants. Contralateral motorevoked potentials (cMEPs) were elicited in left and right biceps brachii (BB) before either elbow flexion or forearm pronation. A neurophysiological index, the excitability ratio (ER), was computed from the relative size of BB cMEPs before each type of movement. Short interval intracortical inhibition (SICI) was assessed in cMEPs of right BB with paired-pulse TMS of left M1. Ipsilateral MEPs (iMEPs) and silent periods (iSPs) were measured in left BB with single-pulse TMS of left M1. Low-intensity cTBS was expected to suppress corticospinal output from left M1. A sham condition was also included. Real but not sham cTBS caused increases in BB ER bilaterally. In the right arm, ER increased because BB cMEPs before flexion were less facilitated, whereas cMEPs in the pronation task were unaffected. This was accompanied by an increase in left M1 SICI. In the left arm, ER increased because BB cMEPs before pronation were facilitated but were unaffected in the flexion task. There was also facilitation of left BB iMEPs. These changes in the left arm are consistent with inappropriate facilitation of left BB ␣-motoneurons (␣MNs) before pronation. This is the first demonstration that cTBS of M1 can alter excitability of neurons controlling ipsilateral proximal musculature and degrade ipsilateral upper limb motor control, providing evidence that ipsilateral and contralateral M1 shape the spatial and temporal characteristics of proximal muscle activation appropriate for the task at hand.

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Section: Discussionmentioning

confidence: 99%

Theta Burst Stimulation of Human Primary Motor Cortex Degrades Selective Muscle Activation in the Ipsilateral Arm

Bradnam

Stinear

Byblow³

2010

Journal of Neurophysiology

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“…TBS has a biological rationale by imitating normal firing patterns in the hippocampus which is bolstered by the observation in animals that TBS induces longterm potentiation and depression which constitute mechanisms of plasticity. 6 iTBS transiently increased MEPs as in stroke, 14,15 but recruitment and cortical silent period remained unchanged. Silent period correlates with dopamine deficiency 16 and response to medication.…”

Section: Updrsmentioning

confidence: 99%

Intermittent theta-burst transcranial magnetic stimulation for treatment of Parkinson disease

Benninger¹,

Berman²,

Houdayer³

et al. 2011

Neurology

138

189

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“…Low frequency stimulation and cTBS stimulation are applied over the non-lesioned hemisphere to decrease the excitability, while the high frequency and iTBS stimulation enhances the excitability and they are used over the lesioned hemisphere. Both treatments led to a faster movement in the paretic hand, and decreased the reaction time in slight cases of stroke [23][24][25][26]. The 3 Hz stimulation showed a more pronounced effect than 10 Hz stimulation assessed by NIHSS after one year [27].…”

Section: Influence On Different Symptoms Of Stroke With Noninvasive Bmentioning

confidence: 99%

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

2014

Int J Neurorehabilitation Eng

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Two non-invasive brain stimulations have spread all over the world: repetitive trasncranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). TMS is based on the current induction with a changing electromagnetic field in the nervous system [1] while tDCS changes the polarity of cell membranes [2]. General Aspects of TMS and tDCSTMS is widely used in research and daily medical practice. It was introduced as a diagnostic tool about thirty years ago to test functioning of motor pathways [3]. The motor evoked potential (MEP) and the measurement of the central motor conduction time (CMCT) has entered into daily practice. The other parameters of the electrophysiological examination assessed by TMS are mainly used in scientific work [4]. TMS aids the diagnosis of multiple sclerosis, furthermore the prognosis of stroke can be indicated by TMS [5]. Different paired pulse stimulations with TMS give a new insight into the function of the brain. In recent years, sophisticated brain plasticity can be detected by the measurement of intracortical excitability [6,7]. We learnt from these studies how different conditions can modify brain plasticity. It can be changed by different diseases, altered by drugs [8] and strongly influenced by non-invasive stimulations [2,9]. The single TMS and one session of repetitive stimulation have a short after-effect. However the effect of repeated stimulation for days exceeds the stimulation period and many times it lasts for months. This effect of rTMS has made it useful for therapy for the last 20 years. The low and high frequency stimulation, continuous theta burst stimulation (cTBS), intermittent theta burst stimulation (iTBS), anodal or cathodal stimulation are used for therapy. The intensity of rTMS was around the motor threshold and the duration of stimulation was 7-10 days. This paper reviews the most frequently studied symptoms of Parkinson's diseases and stroke although rTMS has been tried to treat all disorders of the central nervous system (CNS). Parkinson's Disease (PD)The first protocol was low frequency, low intensity monophasic stimulation for 7 days which improved the Parkinsonian symptoms and its results were maintained for several months after the stimulation [10,11]. The authors performed a "dose (intensity) response" curve with 1 Hz stimulation and they indicated that there is an optimal intensity using 1 Hz [12]. We learned from these studies that the therapeutic effect of rTMS develops after a delay in time of a few weeks. The improvement can be maintained for several months. The later studies confirmed these observations not only in PD but other diseases. Although, the high frequency stimulations over the primary motor cortex [13,14] had the same effect on the Parkinsonian scores but the after-effect lasted for a shorter time. iTBS over the dorsolateral prefrontal area improved the depression without effecting on bradykinesia [15]. The studies concentrated on varying the frequency which was applied but they did not try to find the optimal in...

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Exploring Theta Burst Stimulation as an intervention to improve motor recovery in chronic stroke

Cited by 240 publications

References 35 publications

Theta Burst Stimulation of Human Primary Motor Cortex Degrades Selective Muscle Activation in the Ipsilateral Arm

Theta Burst Stimulation of Human Primary Motor Cortex Degrades Selective Muscle Activation in the Ipsilateral Arm

Intermittent theta-burst transcranial magnetic stimulation for treatment of Parkinson disease

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

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