Zou Xiaoli, Zhu Jiaju, Hu Song, Hou Zhen, Ma Guodong
College of Sports and Human Sciences, Jilin University of Physical Education, Changchun, Jilin 130022, China.
Sports College, Northeast Normal University, Changchun, Jilin 130024, China.
J Neurosci Methods. 2025 Sep;421:110470. doi: 10.1016/j.jneumeth.2025.110470. Epub 2025 May 6.
Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising non-invasive brain stimulation (NIBS) system for post-stroke motor rehabilitation. However, its underlying mechanisms are still not well understood.
In this research, 170 post-stroke patients with motor impairments were randomly divided into an rTMS intervention group (n = 85) and a control group (n = 85). Along with routine motor rehabilitation exercises, the rTMS group received 30 minutes of 5 Hz rTMS over the left Dorsolateral Prefrontal Cortex (DPC) three times a week for 30 days. Sham rTMS treatment can be allocated to the control group. Resting-state functional magnetic resonance imaging (rs-fMRI) was used to evaluate brain activity and functional connectivity (FC) in motor-related areas.
Both the intervention and control groups showed significant motor function improvements, but the rTMS group had more substantial gains. In the intervention group, FCA values in motor regions such as the primary motor cortex (PMC) and Precentral Gyrus (PCG) improved. There was also an increase in FC between the DPC and motor areas.
Unlike some previous studies that may have focused only on motor function improvement without in-depth exploration of brain activity and connectivity changes, this study used rs-fMRI to comprehensively analyze the cerebral functional alterations induced by rTMS, providing a more detailed understanding of the underlying mechanisms of rTMS in post-stroke rehabilitation.
The findings suggest that rTMS promotes motor recovery in post-stroke patients by modulating brain activity and connectivity within motor networks.
重复经颅磁刺激（rTMS）是一种用于中风后运动康复的很有前景的非侵入性脑刺激（NIBS）系统。然而，其潜在机制仍未得到充分理解。
在本研究中，170名有运动障碍的中风后患者被随机分为rTMS干预组（n = 85）和对照组（n = 85）。除了常规的运动康复锻炼外，rTMS组每周三次在左侧背外侧前额叶皮质（DPC）接受30分钟5赫兹的rTMS，共30天。假rTMS治疗可分配给对照组。静息态功能磁共振成像（rs-fMRI）用于评估运动相关区域的脑活动和功能连接（FC）。
干预组和对照组的运动功能均有显著改善，但rTMS组的改善更为明显。在干预组中，初级运动皮层（PMC）和中央前回（PCG）等运动区域的FC值有所改善。DPC与运动区域之间的FC也有所增加。
与一些以往可能仅关注运动功能改善而未深入探索脑活动和连接变化的研究不同，本研究使用rs-fMRI全面分析了rTMS诱导的脑功能改变，从而更详细地了解rTMS在中风后康复中的潜在机制。
研究结果表明，rTMS通过调节运动网络内的脑活动和连接来促进中风后患者的运动恢复。
