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July2005 Vol.42 Issue:        2        Table of Contents
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Therapeutic Effect of Repetitive Transcranial Magnetic Stimulation on Motor Function Recovery after Acute Ischemic Stroke

Eman M. Khedr1, Mohamed Abdel Rahman1, Ola A. Shawky1,Nehal Fathy2, Effet Awad3
Departments of Neuropsychiatry1, Physical Medicine2, Physiology3, Assiut University


Background and purpose: Repetitive transcranial magnetic stimulation (rTMS) is increasingly used as a therapeutic tool in various neurological and psychiatric disorders1. In the present study we evaluated the effect of rTMS of the primary motor cortex (M1) on motor recovery in 52 consecutive patients with acute ischemic stroke of middle cerebral artery territory as documented by computerized tomography. Methods: Patients were randomly assigned to one of two groups, the groups receiving either real-rTMS (10 trains at 3 Hz, 10 s for each train with an inter-train interval of 60 s and an intensity of 120% of resting motor threshold using a figure-of-eight coil positioned over the M1 of the affected hemisphere) or sham-rTMS for 10 consecutive days. Clinical assessment of motor disability and functional activity using the Scandinavian Stroke Scale (SSS), National Institutes of Health Stroke Scale (NIHSS), and Barthel Index Scale (BI), was done for each patient before rTMS (pre-rTMS), at the end of the last treatment session and 10 days later. Motor evoked potentials (MEP) were recorded from abductor digiti minimi at the time of each motor assessment. Results: There were no significant differences between the two groups of patients in the pre-rTMS assessments. However, a two factor ANOVA on each of the clinical measures revealed a significant “group” X “time” interaction indicating that real and sham rTMS had different effects on SSS, NIHSS, and BI. No subject experienced adverse effects during the study. Conclusion: We conclude that repeated application of rTMS over the primary motor cortex of the affected hemisphere can enhance motor function recovery in patients with acute ischemic stroke.

(Egypt J. Neurol. Psychiat. Neurosurg., 2005, 42(2): 417-428).


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