Department of Physical Therapy & Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA.
NeuroRehabilitation. 2013;33(2):185-93. doi: 10.3233/NRE-130944.
To determine the impact of a single-session of repetitive transcranial magnetic stimulation (rTMS) and an rTMS intervention on neurophysiology and motor control in survivors of stroke.
Twelve stroke survivors were randomized into functional-rTMS or passive-rTMS conditions. Measures of short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF), and force steadiness (coefficient of variation, CV) at 10 and 20% of maximum voluntary contraction were assessed at baseline and after a single-session of rTMS (post single-session), and again following an intervention of 8 rTMS sessions (2 sessions per day; post-intervention). Functional-rTMS required subjects to exceed a muscle activation threshold assessed by surface electromyography to trigger each rTMS train; the passive-rTMS group received rTMS while relaxed.
ICF scores significantly increased following the single-session of functional-rTMS compared to the decrease following passive-rTMS. The increase in APB SICI and ICF scores following the intervention was significantly greater for the functional-rTMS group compared to the decreases following passive-rTMS. The groups were significantly different in the CV of force (20%) following the single-session of rTMS, and in the 10 and 20% tasks following the intervention. The functional-rTMS group increased steadiness overtime, whereas the passive group demonstrated a return to baseline following the intervention session. No differences were observed in first dorsal interosseus (FDI) measures (SICI and ICF) between groups.
The functional-rTMS protocol enhanced cortical excitability following a single-session and after repeated sessions and improved steadiness, whereas the passive stimulation protocol tended to decrease excitation and no improvements in steadiness were observed.
确定单次重复经颅磁刺激（rTMS）和 rTMS 干预对中风幸存者的神经生理学和运动控制的影响。
将 12 名中风幸存者随机分为功能性 rTMS 或被动 rTMS 组。在基线时以及单次 rTMS 后（单次后）和 8 次 rTMS 干预后（2 次/天；干预后），评估短程皮质内抑制（SICI）和皮质内易化（ICF）的测量值以及 10%和 20%最大自主收缩力的力稳定性（变异系数，CV）。功能性 rTMS 需要受试者通过表面肌电图来超过肌肉激活阈值，以触发每个 rTMS 训练；被动 rTMS 组在放松时接受 rTMS。
与被动 rTMS 相比，功能性 rTMS 单次治疗后 ICF 评分显著增加。与被动 rTMS 相比，功能性 rTMS 组干预后 APB SICI 和 ICF 评分的增加显著更大。在 rTMS 单次治疗后，以及在干预后的 10%和 20%任务中，两组之间的力（20%）CV 存在显著差异。在单次 rTMS 后以及干预后，功能性 rTMS 组的稳定性逐渐提高，而被动组在干预后恢复到基线。在两组之间，第一背侧骨间肌（FDI）的 SICI 和 ICF 测量值（SICI 和 ICF）没有差异。
功能性 rTMS 方案在单次治疗后和重复治疗后增强了皮质兴奋性，并提高了稳定性，而被动刺激方案则倾向于降低兴奋度，并且没有观察到稳定性的改善。
