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Related Experiment Video

Updated: Jun 23, 2026

Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
10:15

Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia

Published on: July 2, 2013

Stratification algorithm for repetitive TMS in stroke (START): Results from an exploratory crossover study.

Yin-Liang Lin1, Kelsey A Potter-Baker2, Vishwanath Sankarasubramanian3

  • 1Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.

Journal of the Neurological Sciences
|April 10, 2025
PubMed
Summary
This summary is machine-generated.

Stroke survivors benefit from tailored brain stimulation. A new algorithm (START) uses Fugl-Meyer scores to guide whether inhibitory or facilitatory stimulation best aids upper extremity recovery.

Keywords:
Brain stimulationInterhemispheric inhibition (IHI)NeuromodulationRepetitive transcranial magnetic stimulation (rTMS)Stroke

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Last Updated: Jun 23, 2026

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Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
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Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke

Published on: June 6, 2025

Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Neuromodulation

Background:

  • Contralesional motor cortices play a variable role in stroke recovery.
  • Optimal measures to stratify patients for brain stimulation are needed.
  • Understanding structural reserve is key for personalized neuromodulation.

Purpose of the Study:

  • To establish severity criteria for stratifying stroke patients for contralesional M1 inhibition vs. cPMd facilitation.
  • To determine optimal repetitive transcranial magnetic stimulation (rTMS) protocols based on patient impairment.
  • To introduce a framework for targeted neuromodulation in upper extremity (UE) motor recovery.

Main Methods:

  • Twenty-four chronic stroke participants received inhibitory (1 Hz) M1 rTMS, facilitatory (5 Hz) cPMd rTMS, or sham rTMS.
  • Motor performance on a reaching task (RT) was assessed pre- and post-stimulation.
  • Baseline UE Fugl-Meyer (UEFM), fractional anisotropy, and motor evoked potentials (MEPs) were measured.

Main Results:

  • A UEFM score of 42 effectively stratified patients for differential rTMS response.
  • Patients with UEFM > 42 showed greater RT gains with inhibitory M1 rTMS.
  • Patients with UEFM ≤ 42 showed greater RT gains with facilitatory cPMd rTMS.

Conclusions:

  • The findings support a bimodal theory of motor recovery and introduce the START framework.
  • The START algorithm utilizes clinical impairment and white matter integrity for response stratification.
  • Further validation is needed to refine targeted neuromodulation treatments for stroke survivors.