High-frequency rTMS using a double cone coil for gait disturbance

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Medical Engineering

Background:

• Stimulating deep brain regions like leg motor areas for stroke rehabilitation is challenging with conventional figure-of-eight coils.
• A double cone coil offers improved depth penetration for stimulating these deep neural pathways.

Purpose of the Study:

• To investigate the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) applied to bilateral leg motor areas using a double cone coil.
• To assess the impact of this intervention on walking function in patients with post-stroke hemiparesis.

Main Methods:

• A double-blind, cross-over study involving 18 post-stroke patients with gait disturbances.
• High-frequency (10 Hz) rTMS was applied bilaterally to leg motor areas for 20 minutes using a double cone coil.
• Sham stimulation served as a control, with walking velocity and Physiological Cost Index (PCI) measured pre- and post-intervention.

Main Results:

• Walking velocity significantly increased for 20 minutes post-rTMS compared to sham stimulation.
• Physiological Cost Index (PCI) showed a significant decrease immediately after rTMS compared to sham.

Conclusions:

• High-frequency rTMS over bilateral leg motor areas with a double cone coil demonstrates potential for enhancing walking function in stroke survivors.
• This non-invasive neuromodulation technique may be a valuable tool in stroke gait rehabilitation.