Functional neuromuscular stimulation to improve severe hand dysfunction after stroke: Does inhibitory rTMS enhance therapeutic efficiency?

Theilig, Steven; Podubecká, J.; Bösl, Kathrin; Wiederer, Ralf; Nowak, Dennis A.

doi:10.1016/j.expneurol.2011.04.010

Cited by 55 publications

(86 citation statements)

References 39 publications

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“…28,29,35,36,38,41 However, other reports did not show measurable therapeutic effects of rTMS on motor function after stroke. [42][43][44] Because of the inconsistent findings and methodological discrepancies across these trials, there is a lack of consensus regarding the effect of rTMS on motor recovery in patients with stroke.…”

mentioning

confidence: 99%

Effects of Repetitive Transcranial Magnetic Stimulation on Motor Functions in Patients With Stroke

Hsu

Cheng

Liao

et al. 2012

Stroke

308

234

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Background and Purpose-The purpose of this study was to perform a meta-analysis of studies that investigated the effects of repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function in patients with stroke. Methods-We searched for randomized controlled trials published between January 1990 and October 2011 in PubMed, Medline, Cochrane, and CINAHL using the following key words: stroke, cerebrovascular accident, and repetitive transcranial magnetic stimulation. The mean effect size and a 95% CI were estimated for the motor outcome and motor threshold using fixed and random effect models. Results-Eighteen of the 34 candidate articles were included in this analysis. The selected studies involved a total of 392 patients. A significant effect size of 0.55 was found for motor outcome (95% CI, 0.37-0.72). Further subgroup analyses demonstrated more prominent effects for subcortical stroke (mean effect size, 0.73; 95% CI, 0.44 -1.02) or studies applying low-frequency rTMS (mean effect size, 0.69; 95% CI, 0.42-0.95). Only 4 patients of the 18 articles included in this analysis reported adverse effects from rTMS. Conclusions-rTMS has a positive effect on motor recovery in patients with stroke, especially for those with subcortical stroke. Low-frequency rTMS over the unaffected hemisphere may be more beneficial than high-frequency rTMS over the affected hemisphere. Recent limited data suggest that intermittent theta-burst stimulation over the affected hemisphere might be a useful intervention. Further well-designed studies in a larger population are required to better elucidate the differential roles of various rTMS protocols in stroke treatment. (Stroke. 2012;43:1849-1857.)

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mentioning

confidence: 99%

Effects of Repetitive Transcranial Magnetic Stimulation on Motor Functions in Patients With Stroke

Hsu

Cheng

Liao

et al. 2012

Stroke

308

234

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“…However, this task proves difficult in patients with degenerative neurons that are harder to stimulate, therefore, researchers have postulated that audiovisual stimulation can use different pathways to stimulate mirror neurons, activating the degenerative ones [22]. A study examining this concept in patients with left hemiparesis secondary to stroke found that in-person demonstration of the required task resulted in improved ability to perform the task, reduced execution time to perform the task, and increased EEG activity, perhaps correlating to neuronal recruitment during task performance [11]. Audio and visual stimulation has also been shown to increase cognitive performance.…”

Section: Visual and Auditory Brain Stimulationmentioning

confidence: 99%

“…Several recent studies have explored the connection between the role of excitability changes in perilesional cortex and neuronal plasticity, as well as functional motor outcomes [10,11]. Moreover, neuromodulation also has neuroprotective properties, by reducing toxic substances to neurons which subsequently lead to improvements in cognitive impairments, such as working memory and executive abilities, in patients with dementia [12,13].…”

Section: Introductionmentioning

confidence: 99%

The Promising Role of Neuromodulation in Improving Ischemic Stroke Recovery

LoPresti¹,

Camacho²,

Appelboom³

et al. 2015

J Neurol Neurosurg

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Strokes continue to be a leading cause of death and carries significant morbidity impacting the quality of life for survivors. Although there are preventative measures and growing hyperacute treatments, physical and occupational rehabilitation continue to be the main modalities for recovery of motor abilities, cognitive function, and resolution of pain syndromes post-stroke. Neuromodulation therapies hold great promise for stroke survivors and are beginning to gain traction as the next frontier in regards to post-stroke rehabilitation. It is the aim of this review to explore current beliefs regarding post-acute stroke recovery through neuroplasticity of surviving brain tissue and the impact of neuromodulation through non-invasive and invasive interventions. By understanding the scope of these interventions, the areas in which neuromodulation may be most effective, and the types of recovery they may help constitute, the impact of neuromodulation as a budding area in neurological care and therapy can be better characterized and outlined for future study.

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“…В PubMed найдено 16 исследований по изучению влияния ТМС на спастичность [46, [128][129][130][131][132][133][134][135][136][137][138][139][140][141][142]. Среди всех исследований только шесть являются двойными слепыми и имеют группу контроля [128][129][130][131][132][133].…”

Section: спастичностьunclassified