Effects of Transcranial Magnetic Stimulation on Patients of Poststroke Upper Extremity Motor Impairment: A Randomized Controlled Trial.

OBJECTIVE

This study compared the effects of continuous theta burst stimulation and low-frequency repetitive transcranial magnetic stimulation on cortical activity modulation and upper limb motor recovery in subacute stroke patients.

DESIGN

A total of 105 subacute stroke patients with unilateral upper limb impairment were randomly divided into the following three groups: continuous theta burst stimulation, low-frequency repetitive transcranial magnetic stimulation, and sham. Main outcomes included upper extremity Fugl-Meyer score and modified Barthel Index scores at baseline, 4 wks (posttreatment), and 12 wks (follow-up). Secondary outcomes evaluated cortical activation via functional near-infrared spectroscopy.

RESULTS

Among 103 recruited participants, 98 completed follow-up. Both continuous theta burst stimulation and low-frequency repetitive transcranial magnetic stimulation groups showed significantly greater upper extremity Fugl-Meyer improvement than the sham group at 4 and 12 wks ( P < 0.05), while modified Barthel Index scores did not differ significantly. Functional near-infrared spectroscopy revealed that active treatments suppressed contralesional primary motor cortex activation, with continuous theta burst stimulation additionally inhibiting premotor and supplementary motor areas.

CONCLUSIONS

Continuous theta burst stimulation and low-frequency repetitive transcranial magnetic stimulation effectively enhanced upper limb motor motricity in stroke patients compared to sham stimulation, suggesting their potential as noninvasive neuromodulatory therapies for poststroke rehabilitation.