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

W Kakuda1, M Abo, Y Nakayama

  • 1Department of Rehabilitation Medicine, Jikei University School of Medicine, Tokyo, Japan. wkakuda@jikei.ac.jp

Acta Neurologica Scandinavica
|February 13, 2013
PubMed
Summary

High-frequency repetitive transcranial magnetic stimulation (rTMS) using a double cone coil improved walking speed and reduced the Physiological Cost Index in stroke patients. This non-invasive brain stimulation shows potential for gait rehabilitation.

Keywords:
gait disturbancephysiological Cost Indexstroketranscranial magnetic stimulationwalking velocity

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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.