Effect Of Low Frequence Repetitive Transcranial Magnetic Stimulation On The Recovery Of Motor Function In The Patients With Acute Stroke

Objective: To study the effect of low frequence repetitive transcranial magnetic stimulation(rTMS)on the recovery of motor function in the patients with acute stroke.Methods: Thirty initial stroke with hemiparalysis were divided into three groups: rTMS of the unaffected hemisphere group (rTMS+pharmacotherapy)(10),rTMS of the affected hemisphere group(rTMS+pharmacotherapy) (10),and pharmacotherapy group(only pharmacotherapy) (10).The three groups were assessed by motor function scores(NIHSS,ADL scores) and corticospinal excitability(MEP latency period and CMCT )before and after ten and forty days of treatment. Three patients were chosed in each group randomly.Each of them accepted MRS examination before treatment and after forty days of treatment and also assessed by the scores of NAA/Cr.Results:Before treatment the scores of NIHSS,ADL and MEP latency period and CMCT have no statistical significance in the three groups(P>0.05).And before treatment the scores of NAA/Cr have no difference.After treatment, the clinical function scores in the three groups were obviously higher than the scores before treatment (P<0.01).And the degree of motor function improvement in the rTMS of the unaffected hemisphere group is higher than in the other two groups(P<0.01 or P<0.05 )(include the score of both the NIHSS and BI). The degree of motor function improvement in the rTMS of the affected hemisphere group also surpass the compared group (P<0.01).The neuroelectricity physiological index in the three groups after treatment gain improvement in comparision to before treatment.The CMCT in the rTMS of the unaffected hemisphere group become shorter than the CMCT in the rTMS of the affected hemisphere group when 40d after treatment(P<0.05)and also shorter than the CMCT in the compared group when10d and 40d after treatmen(tP<0.05 or P<0.01).The CMCT has no difference between the rTMS of the affected hemisphere group and compared group.But there is a shortening tendency in the rTMS of the affected hemisphere group. The MEP in the rTMS of the unaffected hemisphere group become shorter when comared with the first day(.P<0.01).The CMCT in the other two groups has no difference when comared with the first day.The MEP in the three groups has no difference.But the MEP in the rTMS of the unaffected hemisphere group has better shortening tendency.And after treatment,athough there is no difference about the scores of NAA/Cr in the rTMS of the unaffected hemisphere group and the rTMS of the affected hemisphere group. But there is a better ascensus tendency about the scores of NAA/Cr in the two groups compared with the controlled group.Conclusions:1HZ 70%(3T)rTMS of the hemisphere both unaffected and affected can improve the motor function in the patients with acute stroke. But the rTMS of the unaffected hemisphere group can produce better effects.