Repetitive Transcranial Magnetic Stimulation for Upper Extremity Motor Recovery: Does It Help?

Schambra, Heidi M.

doi:10.1007/s11910-018-0913-8

Cited by 15 publications

(8 citation statements)

References 58 publications

(91 reference statements)

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“…This plasticity may translate to faster processing speed, increased perception and sensitivity, and faster motor responses. Remodeling of sensory maps after rTMS application was also documented in the cat's visual cortex [18] and is believed to be linked to behavioral gains [45], and is also well documented after stroke where it is considered beneficial for recovery [46]. The basis of the fMRI blood-oxygenation-level-dependent (BOLD) contrast is neurovascular coupling.…”

Section: Discussionmentioning

confidence: 97%

Multi-session delivery of synchronous rTMS and sensory stimulation induces long-term plasticity

Zhong¹,

Cywiak²,

Metto³

et al. 2021

Brain Stimulation

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Background:Combining training or sensory stimulation with non-invasive brain stimulation has shown to improve performance in healthy subjects and improve brain function in patients after brain injury. However, the plasticity mechanisms and the optimal parameters to induce long-term and sustainable enhanced performance remain unknown. Objective: This work was designed to identify the protocols of which combining sensory stimulation with repetitive transcranial magnetic stimulation (rTMS) will facilitate the greatest changes in fMRI activation maps in the rat's primary somatosensory cortex (S1). Methods: Several protocols of combining forepaw electrical stimulation with rTMS were tested, including a single stimulation session compared to multiple, daily stimulation sessions, as well as synchronous and asynchronous delivery of both modalities. High-resolution fMRI was used to determine how pairing sensory stimulation with rTMS induced short and long-term plasticity in the rat S1. Results: All groups that received a single session of rTMS showed short-term increases in S1 activity, but these increases did not last three days after the session. The group that received a stimulation protocol of 10 Hz forepaw stimulation that was delivered simultaneously with 10 Hz rTMS for five consecutive days demonstrated the greatest increases in the extent of the evoked fMRI responses compared to groups that received other stimulation protocols. Conclusions: Our results provide direct indication that pairing peripheral stimulation with rTMS induces long-term plasticity, and this phenomenon appears to follow a time-dependent plasticity mechanism. These results will be important to lead the design of new training and rehabilitation paradigms and training towards achieving maximal performance in healthy subjects.

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Section: Discussionmentioning

confidence: 97%

Multi-session delivery of synchronous rTMS and sensory stimulation induces long-term plasticity

Zhong¹,

Cywiak²,

Metto³

et al. 2021

Brain Stimulation

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“…The resulting change in electric potential in the cerebral cortex near the skull causes a depolarization of neurones with triggering of action potentials ( 36 , 42 , 43 ). Studies carried out to date have shown results with a high level of evidence for various applications in the field of neurology ( 40 , 41 ). Examples of the use of EMI in other medical specialties have, so far, been rare but promising ( 16 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

Electromagnetic Induction for Treatment of Unspecific Back Pain: A Prospective Randomized Sham-Controlled Clinical Trial

Hartard¹,

Fenneni

Scharla

et al. 2023

JRM

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Objective: To evaluate the effects of high-energy pulsed electromagnetic fields on unspecific back pain. Methods: A prospective, randomized, sham-controlled clinical trial with repeated measurements was performed. The study included 5 visits (V0 to V4) with 3 interventions during V1, V2 and V3. Sixty-one patients aged between 18 and 80 years with unspecific back pain (acute inflammatory diseases and specific causes were reasons for exclusion) were included. The treatment group (n = 31) received 1–2 pulses/s, with an intensity of 50 mT, and an electric field strength of at least 20 V/m on 3 consecutive weekdays for 10 min each time. The control group (n = 30) received a comparable sham therapy. Pain intensity (visual analogue scale), local oxyhaemoglobin saturation, heart rate, blood pressure, and perfusion index were evaluated before (b) and after (a) V1 and V3 interventions. Change in visual analogue scale for V1 (ChangeV1a-b) and V3 (ChangeV3a-b), and ChangeData between V3a and V1b (ChangeV3a–V1b) for the remaining data were calculated (results were mean (standard deviation) (95% confidence interval; 95% CI)).Results: Concerning the visual analogue scale: (i) compared with the control group, the treatment group had higher ChangeV1a–b (–1.25 (1.76) (95% CI –1.91 to –0.59) vs –2.69 (1.74) (95% CI –3.33 to –2.06), respectively), and comparable Change V3a–b (–0.86 (1.34) (95% CI –1.36 to –0.36) vs –1.37 (1.03) (95% CI –1.75 to 0.99), respectively); and (ii) there was a significant marked decrease in Change V3a–1b in the treatment group compared with the control group (–5.15 (1.56) (95% CI –5.72 to –4.57) vs –2.58 (1.68) (95% CI –3.21 to –1.96), p = 0.001, respectively). There was no significant ChangeV3a–V1b in local oxyhaemoglobin saturation, heart rate, blood pressure or perfusion index between the 2 groups and for the same group (before vs after).Conclusion: Non-thermal, non-invasive electromagnetic induction therapy had a significant and rapid influence on unspecific back pain in the treatment group. LAY ABSTRACTBack pain is a health disorder of outstanding epidemiological, medical, and health economic importance. In the case of unspecific back pain, there is no clear specific cause. Electrotherapy is a physical therapy procedure using electric current for therapeutic purposes. Electromagnetic induction can influence many biological processes that are important for therapeutic interventions. A relatively new method is the use of non-invasive, very short, high-energy pulsed electromagnetic fields. Based on the literature, observations, and guidelines available up to February 2023, therapeutically successful use of electromagnetic induction appears possible, particularly in the case of high-energy pulsed electromagnetic fields. Pulsed electromagnetic fields with high-energy pulsed electromagnetic fields are therefore the logical therapeutic extension of high-energy pulsed electromagnetic fields. This study was designed to test the theory that high-energy pulsed electromagnetic fields can reduce unspecific back-pain. The application of electromagnetic induction, short high-frequency and high-energy, but non-thermal, electromagnetic pulses with a magnetic flux density of approximately 50–100 mT was found to reduce unspecific back-pain in the treatment area of the treatment group.

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“…Other studies, moreover, have demonstrated that the suppressive effects of low rTMS can be propagated to other regions not directly stimulated, presumably by functional connections. For instance, low rTMS of the left primary motor cortex reduces motor evoked potentials elicited by single-pulse TMS administered to the right primary motor cortex, an effect presumably mediated by transcallosal projections [14]. The reduction in pain intensity in our study and subsequently reduction in abortive analgesics intake but not in Teepker et al's study may be explained by the use of figureof-eight coil in our study while using round coil in Teepker et al's [12] study assuming that figure-of-eight coil is more effective than round coil as proven by Rollnik et al [15].…”

Section: Discussionmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation as a prophylactic treatment in migraine

Hammad

Elsharkawy

Azim

2021

Egypt J Neurol Psychiatry Neurosurg

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Background Clinical applications of transcranial magnetic stimulation (TMS) have shown promising results in the treatment of headache disorders, with migraine being one of the most encountered. Objective To assess the role of low-frequency repetitive transcranial magnetic stimulation as a preventive treatment of migraine (with and without aura) and correlate the results with the serum level of the inflammatory biomarker (neurokinin A). Methods Forty patients, with age ranging from 15 to 55 years, diagnosed with migraine (30 migraine without aura and 10 with aura) and 20 apparently healthy individuals, who were age and sex matched with the patient group, were included in this study. A low-frequency (1 Hz) rTMS protocol was applied for all patients for five consecutive days interictally. Assessment of pain intensity using visual analogue scale and frequency and duration of attacks as well as number of pills taken by patients as an abortive treatment according to the Basic Diagnostic Headache Diary for 4 weeks before and 4 weeks after TMS sessions was done. In addition, the Migraine Disability Assessment scale (MIDAS) was applied to assess the severity and degree of disability caused by migraine. Measurement of neurokinin A serum level was done by using ELISA for all patients before and after TMS and for control group once. Results There was a significant reduction in pain intensity, frequency and duration of migraine attacks, migraine disability scores, and number of pills taken as abortive treatment for attacks after rTMS (P < 0.001). Also, serum level of neurokinin A in the patients was significantly reduced after rTMS (P < 0.001). Conclusion Low-frequency rTMS is an effective prophylactic treatment for migraine with and without aura.

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Repetitive Transcranial Magnetic Stimulation for Upper Extremity Motor Recovery: Does It Help?

Cited by 15 publications

References 58 publications

Multi-session delivery of synchronous rTMS and sensory stimulation induces long-term plasticity

Multi-session delivery of synchronous rTMS and sensory stimulation induces long-term plasticity

Electromagnetic Induction for Treatment of Unspecific Back Pain: A Prospective Randomized Sham-Controlled Clinical Trial

Repetitive transcranial magnetic stimulation as a prophylactic treatment in migraine

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