The Effect Of Low-frequency Repetitive Transcranial Magnetic Stimulation On Motor Function Recovery In Ischemic Stroke Patients

Objective: To detect the effect of low-frequency suprathreshold rTMS on MEP latency, wave amplitude and CMCT in the patients after ischemic stroke.Methods: A total of 30 consetutive ischemic stroke patients were prospectively studied in our hospital from May 2007 to April 2008. Patients were randomly assigned to receive ipsilateral M1 stimulation, Contralateral M1 stimulation and without stimulation. Stimulate parameters are 0.5Hz suprathreshold rTMS 100 pulses, 9 sessions, duration was 10 days. MEP latency, wave amplitude and CMCT were detected and recorded at the first day, the tenth day and the fortieth day after treatment by using electroneurophysiology methods.Results: The changes of MEP latency, wave amplitude and CMCT of the patients who received ipsilateral M1 stimulation were more significant (P<0.05) than the baseline and the those of the patients without treatment at the tenth day. The changes of these parameters were even more significant at the fortieth day (P<0.01). There were no significant changes of MEP latency, wave amplitude and CMCT between the patients who received Contralateral M1 stimulation and without stimulation. However, more obviously variation trend were detected.Conclusions: The excitability of cortex were raised by the stimulation of low-frequency suprathreshold rTMS over the both contralesional M1 and ipsilesional M1 in the ischemic stroke patients. The changes of parameters evoked by stimulating ipsilateral M1 were more predominant. Objective: To detect the effect of low-frequency suprathreshold rTMS on score of NIHSS, ADL in the patients after ischemic stroke.Methods: A total of 30 consetutive ischemic stroke patients were prospectively studied in our hospital from May 2007 to April 2008. Three randomized study groups (each group included 10 patients) were treated with ipsilateral M1 rTMS stimulation, Contralateral M1 rTMS stimulation and without stimulation. Stimulattion parameters were 0.5Hz suprathreshold rTMS, 100 pulses, 9 sessions, duration was 10 days. Stroke severity and outcome were evaluated by using the National Institute of Health Stroke Scale (NIHSS ) and the ADL at the first day, the tenth day and the fortieth day of the experiment. One patient was selected randomly in each group, the NAA,Cho,lac and the ratio of NAA/Cr,Cho/Cr were recorded and evaluated by MRS at the first and the fortieth day.Results: Compared with the baseline and the patients without treatment, the change of score of NIHSS decreased significatly in the patients treated with ipsilateral M1 stimulation at the tenth day, contrary to the score of ADL (P<0.05). The changes of these parameters were even more significant at the fortieth day (P<0.01).The same results were gotten in the patients treated with Contralateral M1 stimulation. The change of NAA,Cho,lac and the ratio of NAA/Cr,Cho/Cr were the most significant factors.Conclusions: Low-frequency suprathreshold rTMS over either contralatrel M1 and ipsilateral M1 can improve the neurological deficit and cerebral metabolism. The effect were more predomiant when patients treated with ipsilateral M1 stimulation compared with Contralateral M1 stimulation and the baseline.