Modulating cortical excitability in acute stroke: a repetitive TMS study.

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• Cerebral cortex excitability changes post-stroke, impacting recovery.
• Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability.
• Theta burst stimulation (TBS), a form of rTMS, can induce long-term potentiation (LTP) or depression (LTD)-like changes.

Purpose of the Study:

• To evaluate the effects of TBS on cortical excitability in acute stroke patients.
• To investigate if TBS can modulate excitability in both affected and unaffected hemispheres.

Main Methods:

• 12 acute stroke patients and age-matched healthy controls participated.
• Facilitatory TBS applied to the affected hemisphere and inhibitory TBS to the unaffected hemisphere.
• Cortical excitability assessed using single-pulse TMS and motor evoked potentials (MEPs).

Main Results:

• Both facilitatory TBS (affected hemisphere) and inhibitory TBS (unaffected hemisphere) significantly increased MEP amplitude in stroke patients.
• These effects in patients were comparable to those observed in healthy controls.
• TBS effectively enhanced excitability in the lesioned motor cortex.

Conclusions:

• Facilitatory TBS over the stroke hemisphere and inhibitory TBS over the intact hemisphere enhance lesioned motor cortex excitability in the acute phase.
• TBS shows promise as a tool to promote cortical plasticity and aid recovery in stroke patients.