02 December 2022: Review Articles
Narrative Review of Noninvasive Brain Stimulation in Stroke Rehabilitation
Qian-ru Shen 1AEF* , Meng-ting Hu 1EF* , Wei Feng 1A , Kun-Peng Li 1AEFG** , Wu Wang 2AG*DOI: 10.12659/MSM.938298
Med Sci Monit 2022; 28:e938298
Table 1 Summary of clinical studies on post-stroke patients using rTMS.
| Study | No. | Targeted lesion | Study design | Intervention | Protocol design | Hemisphere | Location | Schedule | Follow-up | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
| Kondo et al, 2013 []21 | 13 | Spastic hemiparesis | CT | LF-rTMS | 1 Hz (90% rMT) | Unaffected | M1 | 20 min, single | N/A | F-mean/M ratio decreased significantly in the affected upper limb |
| Cha et al, 2016 []25 | 30 (15) | Subacute stroke with unilateral neglect | RCT | LF-rTMS vs sham | 1 Hz (90% rMT) | Unaffected | Parietal | 20 min for 20 d | N/A | Line bisection, Albert, Box and block, and Grip strength tests positive |
| Guan et al, 2017 []27 | 42 (21) | Acute ischemic stroke | RCT | HF-rTMS vs sham | 5 Hz (120% rMT) | Affected | M1 | 50 trains of 20 pulses for 10 d | 1 mo, 3 mo, 6 mo, 1 yr | NIHSS, BI, FMA-UL positive for 1 mo, FMA-UL positive for 1 yr |
| Yang et al, 2017 []30 | 60 | Subacute stroke with unilateral neglect | RCT | LF-rTMS | 1 Hz (90% rMT) | Unaffected | Parietal | 900 pluses for 14 d | 6 weeks | Behavioral Inattention Testpositive |
| Sasaki et al, 2017 []26 | 21 (11) | Hemispheric stroke lesion in the early phase | RCT | HF-rTMS | 10 Hz (90% rMT) | Affected | M1 | 10 min twice a day for 5 days | N/A | BRS, ABMS II positive |
| Du et al, 2019 []22 | 60 | First-ever ischemic stroke | RCT | HF-rTMS | 10 Hz (100% rMT) | Affected | M1 | 1200 pulses for 5 d | 3 mo | FMA positive |
| LF-rTMS | 1 Hz (100% rMT) | Unaffected | ||||||||
| Ünlüer et al, 2019 []147 | 30 | Monohemi-spheric stroke | RCT | rTMS vs conventional | 1 Hz (90% rMT) | Unaffected | M1 | 20 min for 5 d | 3 mo | PAS, T-SWAL-QOL positive |
| Wang et al, 2019 []102 | Chronic stroke | RCT | HF-rTMS vs sham | 5 Hz (90% rMT) | Affected | M1 | 15 min, 3 times a week for 3 weeks | 1 mo | Gait performance, spatial asymmetry of gait, and motor function of the lower extremities positive | |
| Hordacre et al, 2020 []29 | 11 | Chronic stroke with depression | RCT | HF-rTMS | 10 Hz (110% rMT) | Affected | DLPFC | 37.5 min for 10 d | 1 mo | BDI positive |
| Zumbansen et al, 2022 []32 | 28 (14) | Chronic versus subacute stroke | RCT | LF-rTMS vs sham | 1 Hz (90% rMT) | Unaffected | Inferior frontal gyrus (Broca’s area) | 15 min, single | 30 d | BNT, SF1min, TT, UnAS positive |
| NIHSS – National Institute of Health stroke scale; BI – the Barthel index of ADL; FMA – Fugl-Meyer Assessment; BRS – Brunnstrom Recovery Stages; ABMS II – Ability for Basic Movement Scale Revised; PAS – the Penetration-Aspiration Scale; T-SWAL-QOL – the Turkish version of The Swallowing Quality of Life; BDI – Beck depression rating scale; BNT – Boston Naming Test; SF1min – semantic fluency test (animals in 1 minute); TT – 36-item Token Test; UnAS – unified aphasia score. | ||||||||||