[Repetitive transcranial magnetic stimulation for the upper limb motor function improvement after stroke].

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Neurology

Background:

• Stroke significantly impacts the brain's motor network, affecting both hemispheres.
• Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique that can alter cortical excitability.
• rTMS holds potential for aiding motor function recovery post-stroke.

Purpose of the Study:

• To systematically review placebo-controlled trials on rTMS for post-stroke hand dysfunction.
• To compare the methodologies and effectiveness of different rTMS application strategies.
• To discuss limitations and future research directions for rTMS in stroke rehabilitation.

Main Methods:

• Systematic literature search for placebo-controlled trials.
• Identification and analysis of 33 relevant studies.
• Comparative analysis of rTMS targeting (a) unaffected hemisphere inhibition, (b) affected hemisphere facilitation, and (c) combined approaches.

Main Results:

• The majority of studies utilized the interhemispheric competition model for rTMS application.
• Effectiveness varied across different rTMS protocols for improving hand function.
• Methodological limitations were noted across the reviewed studies.

Conclusions:

• rTMS strategies, particularly those based on the interhemispheric competition model, are being explored for stroke rehabilitation.
• Further research is needed to optimize rTMS protocols and overcome current limitations for effective stroke recovery.
• Comparative studies highlight the need for refined approaches to rTMS application in treating impaired hand function after stroke.