Repetitive Transcranial Magnetic Stimulation–Induced Corticomotor Excitability and Associated Motor Skill Acquisition in Chronic Stroke

Kim, Yun-Hee; You, Sung Hyun; Ko, Myoung-Hwan; Park, Ji Won; Lee, Kwang Ho; Jang, Sung Ho; Yoo, Woo‐Kyoung; Hallett, Mark

doi:10.1161/01.str.0000221233.55497.51

Cited by 413 publications

(333 citation statements)

References 27 publications

Supporting

Mentioning

298

Contrasting

Unclassified

Order By: Relevance

“…High-frequency rTMS applied to the primary motor cortex resulted in performance improvements in reaction-time tasks 88 and in motor sequence learning. 89 Consistent with these data, application to primary somatosensory cortex produced lasting improvements in two-point tactile discrimination and an enlargement of the right index finger representation in S1, as measured by fMRI. 90 Similar findings have been reported with tDCS.…”

Section: Noninvasive Brain Stimulationsupporting

confidence: 67%

“…Improvements in the JTT are highly relevant to a stroke patient's ability to perform everyday activities and have been shown to correlate well with functional rehabilitation. 104 -106 In a study using a single session of rTMS in patients with chronic stroke, Kim et al 89 showed that high-frequency rTMS (10 Hz) to the ipsilesional M1 resulted in a significantly larger increase in MEP amplitudes than sham rTMS; this increase was associated with an enhanced accuracy during performance of a finger motor sequence task. In a study performed in subacute instead of chronic stroke patients, with multiple sessions of rTMS applied to the ipsilesional M1, Khedr et al 107 used rTMS (10 trains of 3 Hz stimulation, duration 10 seconds, with 50 seconds between each train, twice daily) combined with customary rehabilitative treatment for 10 days within the first 2 weeks after stroke.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Noninvasive brain stimulation in stroke rehabilitation

Webster

Celnik

Cohen

2006

NeuroRX

142

View full text Add to dashboard Cite

Summary:Stroke is a common disorder that produces a major burden to society, largely through long-lasting motor disability in survivors. Recent studies have broadened our understanding of the processes underlying recovery of motor function after stroke. Bilateral motor regions of the brain experience substantial reorganization after stroke, including changes in the strength of interhemispheric inhibitory interactions. Our understanding of the extent to which different forms of reorganization contribute to behavioral gains in the rehabilitative process, although still limited, has led to the formulation of novel interventional strategies to regain motor function. Transcranial magnetic (TMS) and DC (tDCS) electrical stimulation are noninvasive brain stimulation techniques that modulate cortical excitability in both healthy individuals and stroke patients. These techniques can enhance the effect of training on performance of various motor tasks, including those that mimic activities of daily living. This review looks at the effects of TMS and tDCS on motor cortical function and motor performance in healthy volunteers and in patients with stroke. Both techniques can either enhance or suppress cortical excitability, and may move to the clinical arena as strategies to enhance the beneficial effects of customarily used neurorehabilitative treatments after stroke.

show abstract

Section: Noninvasive Brain Stimulationsupporting

confidence: 67%

mentioning

confidence: 99%

Noninvasive brain stimulation in stroke rehabilitation

Webster

Celnik

Cohen

2006

NeuroRX

142

View full text Add to dashboard Cite

show abstract

“…Initial investigations with non-invasive brain stimulation concentrated on using methods of rTMS to improve recovery in acute and chronic stroke (Khedr et al, 2005;Kim et al, 2006). However in recent years there has been increased interest in using tDCS because of two main advantages: firstly it is far less expensive than rTMS, and secondly, stimulation can potentially be applied during rehabilitation whereas rTMS (because the equipment is bulky and the head needs to remain still), it can only be given before (or after) a training session (Brunoni et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: A review and meta-analysis

Triccas

Burridge

Hughes

et al. 2016

Clinical Neurophysiology

View full text Add to dashboard Cite

h i g h l i g h t stDCS and rehabilitation had small non-significant effect on upper extremity impairments. Varied tDCS and rehabilitation programmes were identified in selected studies. Future research needs to further analyse tDCS and therapy interventions in stroke. a b s t r a c tObjective: To systematically review the methodology in particular treatment options and outcomes and the effect of multiple sessions of transcranial direct current stimulation (tDCS) with rehabilitation programmes for upper extremity recovery post stroke. Methods: A search was conducted for randomised controlled trials involving tDCS and rehabilitation for the upper extremity in stroke. Quality of included studies was analysed using the Modified Downs and Black form. The extent of, and effect of variation in treatment parameters such as anodal, cathodal and bi-hemispheric tDCS on upper extremity outcome measures of impairment and activity were analysed using meta-analysis. Results: Nine studies (371 participants with acute, sub-acute and chronic stroke) were included. Different methodologies of tDCS and upper extremity intervention, outcome measures and timing of assessments were identified. Real tDCS combined with rehabilitation had a small non-significant effect of +0.11 (p = 0.44) and +0.24 (p = 0.11) on upper extremity impairments and activities at post-intervention respectively. Conclusion: Various tDCS methods have been used in stroke rehabilitation. The evidence so far is not statistically significant, but is suggestive of, at best, a small beneficial effect on upper extremity impairment. Significance: Future research should focus on which patients and rehabilitation programmes are likely to respond to different tDCS regimes.

show abstract

“…tDCS, depending on the polarity, can also enhance (anodal) or suppress (cathodal) excitability of the targeted cortex [43]. Studies have generally downregulated contralesional activity using low-frequency rTMS [44] or cathodal tDCS [45], or upregulated ipsilesional activity using high-frequency rTMS [46] or anodal tDCS [47], or simultaneously applied both [48,49].…”

Section: Are There Other Processes That Can Be Effective To Modulate mentioning

confidence: 99%

Invasive Neurostimulation in Stroke Rehabilitation

Plow

Machado

2014

Neurotherapeutics

View full text Add to dashboard Cite

The last decade has seen a growing interest in adjuvant treatments that synergistically influence mechanisms underlying rehabilitation of paretic upper limb in stroke. One such approach is invasive neurostimulation of spared cortices at the periphery of a lesion. Studies in animals have shown that during training of paretic limb, adjuvant stimulation targeting the peri-infarct circuitry enhances mechanisms of its reorganization, generating functional advantage. Success of early animal studies and clinical reports, however, failed to translate to a phase III clinical trial. As lesions in humans are diffuse, unlike many animal models, peri-infarct circuitry may not be a feasible, or consistent target across most. Instead, alternate mechanisms, such as changing transcallosal inhibition between hemispheres, or reorganization of other viable regions in motor control, may hold greater potential. Here, we review comprehensive mechanisms of clinical recovery and factors that govern which mechanism(s) become operative when. We suggest novel approaches that take into account a patient's initial clinical-functional state, and findings from neuroimaging and neurophysiology to guide to their most suitable mechanism for ideal targeting. Further, we suggest new localization schemes, and bypass strategies that indirectly target peri-lesional circuitry, and methods that serve to counter technical and theoretical challenge in identifying and stimulating such targets at the periphery of infarcts in humans. Last, we describe how stimulation may modulate mechanisms differentially across varying phases of recovery-a temporal effect that may explain missed advantage in clinical trials and help plan for the next stage. With information presented here, future trials would effectively be able to target patient's specific mechanism(s) with invasive (or noninvasive) neurostimulation for the greatest, most consistent benefit. [2], which remains one of the most important predictors of disability and poor quality of life [3]. Disability adds to the costs of disease management that total $74 billion/ year [4]. Developing methods to effectively alleviate residual deficits will reduce health and economic burden of stroke.Several evidence-based rehabilitative approaches have been developed with prominent ones, including neuromuscular electrical stimulation [5], motor learning [6], robotic training [7] constraint-induced movement therapy [8], and bilateral arm training [9], etc. In spite of extensive therapy, recovery is frequently incomplete [10]. There is a critical need for adjuvant strategies that augment rehabilitative outcomes of paretic hand.The last decade has seen a growing interest in the promise of adjuvant treatments that synergistically influence mechanisms associated with rehabilitation. One such approach is invasive neuromodulation, involving electrical stimulation applied to cortical or subcortical targets spared by stroke. By directly stimulating viable targets, it is believed that potential for plasticity underlying reh...

show abstract

Repetitive Transcranial Magnetic Stimulation–Induced Corticomotor Excitability and Associated Motor Skill Acquisition in Chronic Stroke

Cited by 413 publications

References 27 publications

Noninvasive brain stimulation in stroke rehabilitation

Noninvasive brain stimulation in stroke rehabilitation

Multiple sessions of transcranial direct current stimulation and upper extremity rehabilitation in stroke: A review and meta-analysis

Invasive Neurostimulation in Stroke Rehabilitation

Contact Info

Product

Resources

About