Department of Neurology, Faculty of Medicine, Cairo University, Egypt.
Department of Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt.
NeuroRehabilitation. 2020;47(4):427-434. doi: 10.3233/NRE-203156.
Cortical reorganization between both cerebral hemispheres plays an important role in regaining the affected upper extremity motor function post-stroke.
The purpose of the current study was to investigate the recommended number of contra-lesion low frequency repetitive transcranial magnetic stimulation (LF-rTMS) sessions that could enhance cortical reorganization post-stroke.
Forty patients with right hemiparetic subacute ischemic stroke with an age range between 50-65 yrs 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.
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.
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.
大脑两个半球之间的皮质重组在中风后恢复受影响上肢运动功能方面起着重要作用。
本研究的目的是探讨增强中风后皮质重组的推荐的对侧低频重复经颅磁刺激（LF-rTMS）治疗次数。
将 40 名年龄在 50-65 岁之间的右侧偏瘫亚急性缺血性中风患者随机分为两组：对照组（GA）和研究组（GB）。两组均接受上肢选择性物理治疗方案。两组均每天进行 sham 和真实对侧 LF-rTMS，连续进行两周。在每次治疗结束时计算皮质兴奋性的连续变化。
在研究组（GB）中，第四次治疗时观察到皮质兴奋性显著增强。皮质兴奋性的连续变化率在前八次治疗中具有显著性。从第九次治疗开始，两组之间没有差异。
中风后的恢复模式广泛，并非所有因素都可以控制。LF-rTMS 联合上肢选择性物理治疗方案，从 4 次到 8 次治疗似乎是有效的。
