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Related Experiment Video

Updated: Aug 12, 2025

Author Spotlight: Advancing Upper Limb Rehabilitation in Patients with Right Hemisphere Damage Using Assisted Active Exercise
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Effect of rTMS intervention on upper limb motor function after stroke: A study based on fNIRS.

Jing Ni1,2, Wei Jiang1,2, Xueyang Gong1,3

  • 1Department of Physical Medicine and Rehabilitation, Dushu Lake Hospital Affiliated of Soochow University, Suzhou, Jiangsu, China.

Frontiers in Aging Neuroscience
|January 30, 2023
PubMed
Summary

Repeated transcranial magnetic stimulation (rTMS) effectively improves upper limb function in stroke survivors. A regimen stimulating only the affected hemisphere (TMS2) showed superior results in enhancing brain network parameters and motor recovery compared to combined hemisphere stimulation.

Keywords:
brain functional networkfNIRSrTMSstroke rehabilitationupper limb motor function

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Stroke significantly impairs upper limb motor function, leading to long-term disability and reduced self-care.
  • Repeated transcranial magnetic stimulation (rTMS) shows promise for stroke rehabilitation, but optimal stimulation protocols remain unclear.
  • Controversy exists regarding the necessity of inhibiting the contralesional motor cortex during rTMS for upper limb recovery.

Purpose of the Study:

  • To evaluate the efficacy of different rTMS protocols on upper limb motor function in stroke patients.
  • To analyze the impact of rTMS on brain functional network characteristics.
  • To establish objective criteria based on brain network parameters for guiding rTMS treatment selection.

Main Methods:

  • Thirty-six stroke patients were divided into a control group (sham stimulation) and two treatment groups (TMS1 and TMS2).
  • TMS1 received 1 Hz rTMS on the contralesional M1 + 10 Hz rTMS on the affected M1; TMS2 received 10 Hz rTMS on the affected M1.
  • Assessments included Fugl-Meyer Assessment for upper extremity (FMA-UE) and near-infrared spectroscopy (NIRS) for brain function over 4 weeks.

Main Results:

  • Both rTMS groups showed significant improvements in FMA-UE scores compared to the control group, with TMS2 demonstrating greater improvement at 4 weeks.
  • rTMS modulated cerebral oxygenated hemoglobin (HbO2) levels, decreasing them in the healthy motor cortex and increasing them in the affected motor cortex.
  • Improved motor function correlated with enhanced brain network parameters; TMS2 showed a greater mean increment in these parameters compared to TMS1.

Conclusions:

  • rTMS is beneficial for upper limb motor function recovery in stroke patients, improving brain network connectivity and reducing isolated brain areas.
  • Specific brain network parameters (e.g., M1_Healthy node degree) can guide the choice between unilateral or bilateral rTMS protocols.
  • Tailoring rTMS treatment plans based on individual brain functional network states is crucial for optimizing rehabilitation outcomes.