Intermittent theta-burst stimulation with physical exercise improves poststroke motor function: A systemic review and...

Area of Science:

• Neuroscience
• Rehabilitation Medicine

Background:

• Intermittent theta-burst stimulation (iTBS), an optimized repetitive transcranial magnetic stimulation (rTMS) method, is explored for its potential to modulate neural excitability.
• Previous research on iTBS for stroke motor function recovery remains inconclusive, necessitating further investigation.
• This meta-analysis aims to clarify the efficacy of iTBS in enhancing motor function among stroke survivors.

Approach:

• A comprehensive literature search was conducted across MEDLINE, Embase, and Cochrane Library databases up to May 2022.
• The analysis included thirteen randomized controlled trials (RCTs) involving 334 stroke patients.
• Primary outcome measures were changes in Fugl-Meyer Assessment (FMA) and Motor Assessment Scale (MAS) scores from baseline.

Key Points:

• iTBS significantly improved FMA scores (P=0.002) but not MAS scores (P=0.24) compared to sham stimulation.
• A standard 600-pulse iTBS protocol demonstrated superior motor function improvement (P=0.004) over sham, whereas a 1200-pulse protocol showed no significant effect (P=0.23).
• The benefits of iTBS for motor function were observed in chronic stroke patients (P=0.02) but not in subacute cases (P=0.27).

Conclusions:

• iTBS demonstrates significant efficacy in improving motor function for stroke patients.
• Standard 600-pulse iTBS is a viable therapeutic strategy for managing and treating chronic stroke.
• Further research may explore optimal parameters and patient selection for iTBS in stroke rehabilitation.