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Continuous theta-burst stimulation may improve visuospatial neglect via modulating the attention network: a

Wei Fu1, Lei Cao1, Yanming Zhang1

  • 1a Department of Rehabilitation , Xuanwu Hospital Capital Medical University , Beijing , P.R. China.

Topics in Stroke Rehabilitation
|January 22, 2017
PubMed
Summary

Continuous theta-burst stimulation (cTBS) targeting the left posterior parietal cortex improved visuospatial neglect (VSN) after stroke. This non-invasive brain stimulation altered functional connectivity in the attention network, aiding behavioral recovery.

Keywords:
Continuous theta-burst stimulation (cTBS)Dorsal attention networkPosterior parietal cortexResting-state functional connectivityStrokeVentral attention networkVisuospatial neglect (VSN)

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Area of Science:

  • Neuroscience
  • Neurology
  • Rehabilitation Medicine

Background:

  • Visuospatial neglect (VSN) is a common and debilitating stroke-induced condition.
  • VSN is linked to disruptions within the brain's attention network.
  • Non-invasive brain stimulation techniques like theta-burst stimulation (TBS) show promise for VSN recovery.

Purpose of the Study:

  • To examine the impact of continuous TBS on resting-state functional connectivity (RSFC) within the attention network.
  • To evaluate the effects of cTBS on behavioral outcomes in stroke patients with VSN.

Main Methods:

  • Twelve stroke patients with VSN were randomized into two groups: cTBS or active control.
  • Participants received 10 days of cTBS targeting the left posterior parietal cortex or a sham intervention.
  • Both groups underwent daily visual scanning training and motor therapy, with assessments via fMRI and behavioral tests (line bisection, star cancelation).

Main Results:

  • The cTBS group exhibited reduced functional connectivity between the right temporoparietal junction (TPJ) and right anterior insula, and between the right superior temporal sulcus and right anterior insula compared to controls.
  • Both groups improved behaviorally, but the cTBS group showed significantly greater improvement from baseline.

Conclusions:

  • cTBS of the left posterior parietal cortex can modify inter-regional RSFC in the right ventral attention network in VSN patients.
  • These connectivity changes correlate with enhanced behavioral recovery following training.
  • The TPJ and superior temporal sulcus are identified as key regions involved in VSN recovery.