Effectiveness Of Different Frequencies Of Repetitive Transcranial Magnetic Stimulation On The Restoration Of Limbs Motor Dysfunction And Degree Of Spasm In Patients After Cerebral Infarction

Objective We suggested that different frequencies of transcranial magnetic stimulation may take different affections on upper limb motor function and the degree of spasm in patients with cerebral infarction.To observe the effectiveness of different frequencies of repetitive transcranial magnetic stimulation on the restoration of upper limb motor dysfunction and spasticity degree in patients after cerebral infarctionMethods We designed and fulfilled this randomized control clinical trial,127 cases of patients who were during their subacute stage and finished the trial,were randomly assigned to three repetitive transcranial magnetic stimulation groups,named LF-rTMS(42 cases),HF-rTMS(43 cases)and Sham group(42 cases)respectively.All patients were treated with regular medical treatment and rehabilitation training.LF-rTMS group received 1-Hz rTMS to the contralesional primary motor cortex(M1)(total time 1000s)and HF-rTMS group received 10Hz rTMS on the ipsilesional M1(total time 135s).Sham group with a false coil 10Hz Stimulus frequency that had no stimulation but could sent out sound on the ipsilesional M1(stimulation time equal to HF-rTMS)Cortical latency of motor-evoked potentials,central motor-conduction time,scores on the Fugl-Meyer assessment scale,and scores on the motor assessment scale were evaluated by specialists before treatment and 2 weeks after treatment.The 4 parameters did not significantly different among the three groups(p>0.05)before treatment.Results After treatment,cortical latency of MEP and CMCT scores decreased in all groups after treatment(p<0.05).Decreases in LF-rTMS and HF-rTMS groups were greater than in Sham group(p<0.05).Upper limb function as assessed by the Fugl-Meyer Assessment scale improved in all three groups after treatment,(p<0.05).Improvement in LF-rTMS and HF rTMS groups were significantly greater than that in Sham group(p<0.05).MAS scores for upper limbs function and Modified Bathel Index scales also increased significantly for the three groups after treatment(p<0.05),but no significant differences were observed across the three groups(p>0.05).Modified Ashworth score(MAS)were used to evaluate the degree of spasticity,scores of three groups before treatment had no significant difference(p>0.05),LF-rTMS and HF-rTMS groups significantly improved after treatment(p<0.05),but the Sham group before and after treatment had no significant improvement(p>0.05).After treatment LF-rTMS and HF-rTMS are improved significantly than those of the Sham group(p<0.05).Conclusions Both low-frequency and high-frequency repetitive transcranial magnetic stimulation can promote upper limb motor function after cerebral infarction,but their effects do not appear significantly different,Both the effects of low frequency and high frequency rTMS can improve spasm significantly better than false stimulation group,improve spasticity degree may be one of the pathways to improve the upper limb movement function.further researches of larger samples need to be performed.