rTMS for Poststroke Pusher Syndrome: A Randomized, Patient-Blinded Controlled Clinical Trial

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Clinical Trials

Background:

• Poststroke pusher syndrome (PS) presents significant challenges in rehabilitation and post-discharge care.
• Effective treatments for PS are limited, highlighting the need for novel therapeutic approaches.
• The efficacy of repetitive transcranial magnetic stimulation (rTMS) for PS has not been previously investigated.

Purpose of the Study:

• To evaluate the effectiveness of rTMS in treating poststroke PS.
• To assess rTMS's impact on reducing pushing behavior.
• To determine if rTMS can enhance motor recovery and improve mobility in PS patients.

Main Methods:

• A randomized, patient- and assessor-blinded, sham-controlled trial was conducted.
• Thirty-four patients with poststroke PS received either rTMS or sham rTMS for two weeks.
• Outcomes including pushing behavior, motor function (Fugl-Meyer assessment scale-motor domain), and mobility were assessed at baseline and at one and two weeks post-intervention.

Main Results:

• No significant improvements were observed in pushing behavior (Burke lateropulsion scale, scale for contraversive pushing) or mobility (modified Rivermead mobility index) between the rTMS and sham groups.
• A statistically significant interaction between intervention and time was found for motor function (FMA-m).
• The rTMS group demonstrated better improvement in FMA-m scores at one and two weeks post-treatment compared to the sham group.

Conclusions:

• rTMS did not prove effective in reducing pushing behavior or enhancing mobility in patients with poststroke PS.
• rTMS may hold potential for improving motor function in patients suffering from PS.
• Further research is warranted to explore the specific effects of rTMS on motor recovery in PS.