Multifocal transcranial stimulation in chronic ischemic stroke: A phase 1/2a randomized trial

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• Stroke frequently results in persistent motor deficits.
• Repetitive transcranial magnetic stimulation (rTMS) is explored for post-stroke motor recovery.
• Cortical reorganization is a key mechanism for functional improvement.

Purpose of the Study:

• To evaluate the safety and preliminary efficacy of a new wearable transcranial rotating permanent magnet stimulator (TRPMS) for multifocal bilateral stimulation.
• To investigate if TRPMS can induce functional reorganization of cortical circuits after stroke.
• To assess the impact of TRPMS on motor function recovery in chronic ischemic stroke patients.

Main Methods:

• A Phase 1/2a randomized, double-blind, sham-controlled trial was conducted.
• Thirty patients with chronic ischemic stroke received 20 sessions of TRPMS over 4 weeks.
• Functional MRI (fMRI) and clinical motor scales were used to assess efficacy.

Main Results:

• TRPMS was well-tolerated with no adverse effects.
• Active TRPMS significantly increased active voxels on fMRI compared to sham.
• Numerical improvements in motor function were observed in most clinical scales, persisting for 3 months.

Conclusions:

• Multifocal bilateral TRPMS is safe and induces brain changes indicative of cortical reorganization in stroke survivors.
• The findings suggest potential for TRPMS in promoting motor recovery.
• Larger trials are necessary to confirm clinical benefits for motor function recovery.