Abstract
Objectives
To assess the efficacy of high-frequency (20Hz) brain stimulation on lower limb motor
function in subjects with chronic (>6mo) subcortical stroke.
Design
Double-blind, placebo-controlled crossover study.
Setting
University hospital.
Participants
Right-handed subjects (N=10) affected by a first-ever subcortical stroke in the territory
of the middle cerebral artery were included in this study.
Interventions
Repetitive transcranial magnetic stimulation (rTMS) was delivered with the H-coil,
specifically designed to target deeper and larger brains regions. Each subject received
both real and sham rTMS in a random sequence. The 2 rTMS cycles (real or sham) were
composed of 11 sessions each, administered over 3 weeks and separated by a 4-week
washout period.
Main Outcome Measures
Lower limb functions were assessed by the lower limb Fugl-Meyer scale, the 10-m walk
test, and the 6-minute walk test before and 1 day after the end of each treatment
period, as well as at a 4-week follow-up.
Results
Real rTMS treatment was associated with a significant improvement in lower limb motor
function. This effect persisted over time (follow-up) and was significantly greater
than that observed with sham stimulation. A significant increase in walking speed
was also found after real rTMS, but this effect did not reach statistical significance
in comparison with the sham stimulation.
Conclusions
These data demonstrated that 3 weeks of high-frequency deep rTMS could induce long-term
improvements in lower limb functions in the chronic poststroke period, lasting at
least 1 month after the end of the treatment.
Keywords
List of abbreviations:
ANOVA (analysis of variance), FM (Fugl-Meyer), rTMS (repetitive transcranial magnetic stimulation), 6MWT (6-minute walk test), 10MWT (10-m walk test)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 12, 2014
Footnotes
Supported through the joint Italian-Israeli laboratory on brain modulation in neuroimmune, neurodegenerative, and mental disorders (Italian Ministry of Foreign Affairs).
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated (Chieffo, De Prezzo, Houdayer, Nuara, Di Maggio, Coppi, Ferrari, Straffi, Spagnolo, Velikova, Sessa, Comola, Comi, Leocani).
A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit on the author or one or more of the authors. Zangen is a key inventor of deep TMS H-coils and has financial interest in Brainsway Ltd.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
