Effect of Repetitive Transcranial Magnetic Stimulation in Post-stroke Patients with Severe Upper-Limb Motor Impairment
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Repetitive transcranial magnetic stimulation (rTMS) has been known to improve the motor function through modulation of excitability in the cerebral cortex. However, most studies with rTMS were limited to post-stroke patients with mild to moderate motor impairments. The effect of rTMS on severe upper-limb motor impairment remains unclear. Therefore, this study investigated the effects of rTMS on the upper extremity function in post-stroke patients with severe upper-limb motor impairment. Subjects were divided into 3 groups, low-, high-frequency rTMS and control group were received stimulation 10 times for 2 weeks. The motor scale of Fugl-Meyer Assessment (FMA) and cortical excitability on the unaffected hemisphere were measured before and after performing 10 rTMS sessions. The motor scale of upper extremity FMA (UE-FMA) and shoulder component of the UE-FMA were significantly improved in both low- and high-frequency rTMS groups. However, no significant improvement was observed in the wrist and hand components. No significant differences were noted in low- and high-frequency rTMS groups. The amplitude of motor evoked potential on the unaffected hemisphere showed a significant decrease in the low- and high-frequency stimulation groups. rTMS may be helpful in improving upper extremity motor function even in post-stroke patients with severe upper-limb motor impairment.
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has been known to improve the motor function through modulation of excitability in the cerebral cortex. However, most studies with rTMS were limited to post-stroke patients with mild to moderate motor impairments. The effect of rTMS on severe upper-limb motor impairment remains unclear. Therefore, this study investigated the effects of rTMS on the upper extremity function in post-stroke patients with severe upper-limb motor impairment. Subjects were divided into 3 groups, low-, high-frequency rTMS and control group were received stimulation 10 times for 2 weeks. The motor scale of Fugl-Meyer Assessment (FMA) and cortical excitability on the unaffected hemisphere were measured before and after performing 10 rTMS sessions. The motor scale of upper extremity FMA (UE-FMA) and shoulder component of the UE-FMA were significantly improved in both low- and high-frequency rTMS groups. However, no significant improvement was observed in the wrist and hand components. No significant differences were noted in low- and high-frequency rTMS groups. The amplitude of motor evoked potential on the unaffected hemisphere showed a significant decrease in the low- and high-frequency stimulation groups. rTMS may be helpful in improving upper extremity motor function even in post-stroke patients with severe upper-limb motor impairment.
참고문헌 (39)
- Kim DY, "Enhancing motor performance by anodal transcranial direct current stimulation in subacute stroke patients", Am J Phys Med Rehabil, 88, pp.829~836 (2009)
- Bütefisch CM, "Enhancing encoding of a motor memory in the primary motor cortex by cortical stimulation", J Neurophysiol, 91, pp.2110~2116 (2004)
- 고명환, "10Hz 역치하 반복 경두개자기자극 후 운동피질 흥분도의 지속적 변화", Annals of Rehabilitation Medicine, 30(5), pp.436~440 (2006), 대한재활의학회
- Avenanti A, "Low-frequency rTMS promotes use-dependent motor plasticity in chronic stroke : a randomized trial", Neurology, 78, pp.256~264 (2012)
- Khedr EM, "Role of 1 and 3 Hz repetitive transcranial magnetic stimulation on motor function recovery after acute ischaemic stroke", Eur J Neurol, 16, pp.1323~1330 (2009)
- Khedr EM, "Long-term effect of repetitive transcranial magnetic stimulation on motor function recovery after acute ischemic stroke", Acta Neurol Scand, 121, pp.30~37 (2010)
- Mansur CG, "A sham stimulation-controlled trial of rTMS of the unaffected hemisphere in stroke patients", Neurology, 64, pp.1802~1804 (2005)
- Nowak DA, "Effects of low-frequency repetitive transcranial magnetic stimulation of the contralesional primary motor cortex on movement kinematics and neural activity in subcortical stroke", Arch Neurol, 65, pp.741~747 (2008)
- Boggio PS, "Hand function improvement with low-frequency repetitive transcranial magnetic stimulation of the unaffected hemisphere in a severe case of stroke", Am J Phys Med Rehabil, 85, pp.927~930 (2006)
- Sasaki N, "Comparison of the effects of high-and low-frequency repetitive transcranial magnetic stimulation on upper limb hemiparesis in the early phase of stroke", J Stroke Cerebrovasc Dis, 22, pp.413~418 (2013)
- Luft AR, "Repetitive bilateral arm training and motor cortex activation in chronic stroke : a randomized controlled trial", JAMA, 292, pp.1853~1861 (2004)
- Groppa S, "A practical guide to diagnostic transcranial magnetic stimulation : report of an IFCN committee", Clin Neurophysiol, 123, pp.858~882 (2012)
- Chistyakov AV, "Effect of electroconvulsive therapy on cortical excitability in patients with major depression : a transcranial magnetic stimulation study", Clin Neurophysiol, 116, pp.386~392 (2005)
- Watanabe K, "Comparative study of ipsilesional and contralesional repetitive transcranial magnetic stimulations for acute infarction", J Neurol Sci, 384, pp.10~14 (2018)
- Lüdemann-Podubecká J, "Inhibition of the contralesional dorsal premotor cortex improves motor function of the affected hand following stroke", Eur J Neurol, 23, pp.823~830 (2016)
- Cha HG, "Effects of repetitive transcranial magnetic stimulation on arm function and decreasing unilateral spatial neglect in subacute stroke : a randomized controlled trial", Clin Rehabil, 30, pp.649~656 (2016)
- Zheng CJ, "Effect of combined low-frequency repetitive transcranial magnetic stimulation and virtual reality training on upper limb function in subacute stroke : a double-blind randomized controlled trail", J Huazhong Univ Sci Technolog Med Sci, 35, pp.248~254 (2015)
- Matsuura A, "Magnetic stimulation and movement-related cortical activity for acute stroke with hemiparesis", Eur J Neurol, 22, pp.1526~1532 (2015)
- Sung WH, "Efficacy of coupling inhibitory and facilitatory repetitive transcranial magnetic stimulation to enhance motor recovery in hemiplegic stroke patients", Stroke, 44, pp.1375~1382 (2013)
- Chang WH, "Long-term effects of rTMS on motor recovery in patients after subacute stroke", J Rehabil Med, 42, pp.758~764 (2010)
- Fregni F, "A sham-controlled trial of a 5-day course of repetitive transcranial magnetic stimulation of the unaffected hemisphere in stroke patients", Stroke, 37, pp.2115~2122 (2006)
- Carey JR, "Serial treatments of primed low-frequency rTMS in stroke : characteristics of responders vs. nonresponders", Restor Neurol Neurosci, 32, pp.323~335 (2014)
- 이종화, "Factors Associated With Upper Extremity Motor Recovery After Repetitive Transcranial Magnetic Stimulation in Stroke Patients", Annals of Rehabilitation Medicine, 39(2), pp.268~276 (2015), 대한재활의학회
- Demirtas-Tatlidede A, "Long-term effects of contralesional rTMS in severe stroke : safety, cortical excitability, and relationship with transcallosal motor fibers", NeuroRehabilitation, 36, pp.51~59 (2015)
- Siebner HR, "Transcranial magnetic stimulation : new insights into representational cortical plasticity", Exp Brain Res, 148, pp.1~16 (2003)
- Murase N, "Influence of interhemispheric interactions on motor function in chronic stroke", Ann Neurol, 55, pp.400~409 (2004)
- Merzenich MM, "Somatosensory cortical map changes following digit amputation in adult monkeys", J Comp Neurol, 224, pp.591~605 (1984)
- Sanes JN, "Dynamic organization of primary motor cortex output to target muscles in adult rats. I. Long-term patterns of reorganization following motor or mixed peripheral nerve lesions", Exp Brain Res, 79, pp.479~491 (1990)
- Donoghue JP, "Dynamic organization of primary motor cortex output to target muscles in adult rats. II. Rapid reorganization following motor nerve lesions", Exp Brain Res, 79, pp.492~503 (1990)
- Hoyer EH, "Understanding and enhancing motor recovery after stroke using transcranial magnetic stimulation", Restor Neurol Neurosci, 29, pp.395~409 (2011)
- Nudo RJ, "Repetitive microstimulation alters the cortical representation of movements in adult rats", Somatosens Mot Res, 7, pp.463~483 (1990)
- Harvey RL, "Cortical brain stimulation : a potential therapeutic agent for upper limb motor recovery following stroke", Top Stroke Rehabil, 14, pp.54~67 (2007)
- Zappulla RA, "Noncortical origins of the spinal motor evoked potential in rats", Neurosurgery, 22, pp.846~852 (1988)
- Kamida T, "Conduction pathways of motor evoked potentials following transcranial magnetic stimulation : a rodent study using a"figure-8"coil", Muscle Nerve, 21, pp.722~731 (1998)
- Matsuura A, "Correlation between changes of contralesional cortical activity and motor function recovery in patients with hemiparetic stroke", Phys Ther Rev, 20, pp.28~35 (2017)
- Veldema J, "Cortico-spinal excitability and hand motor recovery in stroke : a longitudinal study", J Neurol, 265, pp.1071~1078 (2018)
- Emara TH, "Repetitive transcranial magnetic stimulation at 1Hz and 5Hz produces sustained improvement in motor function and disability after ischaemic stroke", Eur J Neurol, 17, pp.1203~1209 (2010)
- Takeuchi N, "Repetitive transcranial magnetic stimulation over bilateral hemispheres enhances motor function and training effect of paretic hand in patients after stroke", J Rehabil Med, 41, pp.1049~1054 (2009)
- Chang WH, "Optimal number of pulses as outcome measures of neuronavigated transcranial magnetic stimulation", Clin Neurophysiol, 127, pp.2892~2897 (2016)