Low Frequency Transcranial Magnetic Stimulation in Subacute Ischemic Stroke: Number of Sessions That Altered Cortical Excitability
Engy BadrEldin S. Moustafa1,*, Mohammed S. El-Tamawy2, Moshera H. Darwish1, Saly H. Elkholy3, Shimaa T. Abulkassem4 and Heba A. Khalifa1
1Department of Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt.
2Department of Neurology, Faculty of Medicine, Cairo University, Egypt.
3Department of Clinical Neurophysiology, Faculty of Medicine, Cairo University, Egypt.
4Department of Basic Science, Faculty of Physical Therapy, Cairo University, Egypt.
Citation: Mousstafa EBS, EL-Tamawy MS, Darwish MH, Elkholy SH, Abulkassem ST et al (2021) Low Frequency Transcranial Magnetic Stimulation in Subacute Ischemic Stroke: Number of Sessions That Altered Cortical Excitability. SciTech Mental Health 2021.
Received: July 16, 2021 Accepted: July 17, 2021 Published: July 17, 2021
Abstract
Background: Cortical reorganization between both cerebral hemispheres plays an important role in regaining the affected upper extremity motor function post-stroke.
Objectives: The purpose of the current studywas to investigate the recommended number of contra-lesion low frequency repetitive transcranial magnetic stimulation (LF-rTMS) sessions that could enhance cortical reorganization post-stroke.
Methods: Forty patients with right hemiparetic subacute ischemic stroke with an age range between 50–65 years were randomly assigned into two equal groups: control (GA) and study (GB) groups. Both groups were treated with a selected physical therapy program for the upper limb. Sham and real contra-lesion LF- rTMS was conducted for both groups daily for two consecutive weeks. Sequential changes of cortical excitability were calculated by the end of each session.
Results: The significant enhancement in the cortical excitability was observed at the fourth session in favor of the study group (GB). Sequential rate of change in cortical excitability was significant for the first eight sessions. From the ninth session onwards, no difference could be detected between groups.
Conclusion: The pattern of recovery after stroke is extensive and not all factors could be controlled. Application of LF-rTMS in conjugation with a selected physical therapy program for the upper limb from four to eight sessions seems to be efficient.
Keywords: Cortical excitability, Cortical reorganization, Sequential changes, Single pulse TMS, Transcranial magnetic stimulation, Upper limb motor performance
