Effects of repetitive transcranial magnetic stimulation combined with transcranial direct current stimulation on motor function and cortex excitability in subacute stroke patients: A randomized controlled trial
Objective: To explore effects of repetitive transcranial magnetic stimulation (rTMS) combined with transcranial direct current stimulation (tDCS) on motor function and cortex excitability in subacute stroke patients. Design: Randomized controlled trial. Setting: Inpatient hospitals. Subjects: Sixty-...
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| Veröffentlicht in: | Clinical rehabilitation 2021-05, Vol.35 (5), p.718-727 |
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| creator | Gong, Yan Long, Xian-Ming Xu, Ying Cai, Xiu-Ying Ye, Ming |
| description | Objective:
To explore effects of repetitive transcranial magnetic stimulation (rTMS) combined with transcranial direct current stimulation (tDCS) on motor function and cortex excitability in subacute stroke patients.
Design:
Randomized controlled trial.
Setting:
Inpatient hospitals.
Subjects:
Sixty-five participants were randomly assigned to four groups: sham, 1Hz rTMS, cathodic tDCS combined with 1Hz rTMS (tDCS-/rTMS-) and anodic tDCS combined with 1Hz rTMS (tDCS+/rTMS-).
Interventions:
Four interventions were used, including sham, 1Hz rTMS, and cathodal or anodal tDCS, followed by 1Hz rTMS over contralesional motor cortex, which continued for four weeks.
Main measures:
Outcome measures were motor function and cortical excitability, evaluated by Fugl-Meyer Assessment, National Institutes of Health Stroke Scale and Barthel Index, resting Motion Threshold, Motor Evoked Potentials and Central Motor Conduction Time, assessed at baseline, four weeks and eight weeks.
Results:
At four weeks after interventions, Fugl-Meyer Assessment lower limb change score in tDCS+/rTMS- group was significantly larger than other three groups (P < 0.001). There were significant differences in bilateral Motor Evoked Potentials changes between tDCS+/rTMS- group and sham group (P < 0.05). At eight weeks, compared to other groups, National Institutes of Health Stroke Scale (P = 0.003), Barthel Index (P = 0.002), FMA lower limb score (P < 0.001), and bilateral resting Motion Threshold, Motor Evoked Potentials (P < 0.05) showed significant changes in tDCS+/rTMS- group. Furthermore, Fugl-Meyer Assessment lower limb change score was associated with increased ipsilesional Motor Evoked Potentials (r = 0.703 P < 0.001) in tDCS+/rTMS- group.
Conclusion:
1Hz rTMS combined with anode tDCS stimulation protocol could be a preferable rehabilitative strategy for motor recovery in subacute stroke patients. |
| doi_str_mv | 10.1177/0269215520972940 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2463599660</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0269215520972940</sage_id><sourcerecordid>2517767145</sourcerecordid><originalsourceid>FETCH-LOGICAL-c365t-a5d131cbc4cbd534adc6a8481c5a953047a38643b1f24216f60e1a5404dd05963</originalsourceid><addsrcrecordid>eNp1kU1rFTEYhYNY7LW6dyUBN25G8z0z7kqpH1Bw066HTPJOTZ1JrklGW3-mv8j39lalBSEkIeec5w0cQl5w9obztn3LhOkF11qwvhW9Yo_Ihqu2bVjXysdks5ObnX5InpZyxRjrhOJPyKGUQgjNxIb8Op0mcLXQNNEMW6ihhu9Aa7axONyCneliLyMKjpYalnW2NaRIXVrGEMHTH6F-ue_3ISOSujVniPVeCteSasp0WqO7fbHRIytXuKZw7UK1Y5hDvaEh0rKO1q0VkJDTV6BbZCCwvKPHFEf5tISfsEtH1OcZrzXj_GfkYLJzged35xG5eH96fvKxOfv84dPJ8VnjpNG1sdpzyd3olBu9lsp6Z2ynOu607bVkqrWyM0qOfBJKcDMZBtxqxZT3TPdGHpHXe-42p28rlDosoTiYZxshrWUQykjd98YwtL56YL1Ka474u0FoLNK0XGl0sb3L5VRKhmnY5rDYfDNwNuz6Hh72jZGXd-B1XMD_DfwpGA3N3lDsJfyb-l_gby2VuEQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2517767145</pqid></control><display><type>article</type><title>Effects of repetitive transcranial magnetic stimulation combined with transcranial direct current stimulation on motor function and cortex excitability in subacute stroke patients: A randomized controlled trial</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>MEDLINE</source><source>SAGE Complete</source><creator>Gong, Yan ; Long, Xian-Ming ; Xu, Ying ; Cai, Xiu-Ying ; Ye, Ming</creator><creatorcontrib>Gong, Yan ; Long, Xian-Ming ; Xu, Ying ; Cai, Xiu-Ying ; Ye, Ming</creatorcontrib><description>Objective:
To explore effects of repetitive transcranial magnetic stimulation (rTMS) combined with transcranial direct current stimulation (tDCS) on motor function and cortex excitability in subacute stroke patients.
Design:
Randomized controlled trial.
Setting:
Inpatient hospitals.
Subjects:
Sixty-five participants were randomly assigned to four groups: sham, 1Hz rTMS, cathodic tDCS combined with 1Hz rTMS (tDCS-/rTMS-) and anodic tDCS combined with 1Hz rTMS (tDCS+/rTMS-).
Interventions:
Four interventions were used, including sham, 1Hz rTMS, and cathodal or anodal tDCS, followed by 1Hz rTMS over contralesional motor cortex, which continued for four weeks.
Main measures:
Outcome measures were motor function and cortical excitability, evaluated by Fugl-Meyer Assessment, National Institutes of Health Stroke Scale and Barthel Index, resting Motion Threshold, Motor Evoked Potentials and Central Motor Conduction Time, assessed at baseline, four weeks and eight weeks.
Results:
At four weeks after interventions, Fugl-Meyer Assessment lower limb change score in tDCS+/rTMS- group was significantly larger than other three groups (P < 0.001). There were significant differences in bilateral Motor Evoked Potentials changes between tDCS+/rTMS- group and sham group (P < 0.05). At eight weeks, compared to other groups, National Institutes of Health Stroke Scale (P = 0.003), Barthel Index (P = 0.002), FMA lower limb score (P < 0.001), and bilateral resting Motion Threshold, Motor Evoked Potentials (P < 0.05) showed significant changes in tDCS+/rTMS- group. Furthermore, Fugl-Meyer Assessment lower limb change score was associated with increased ipsilesional Motor Evoked Potentials (r = 0.703 P < 0.001) in tDCS+/rTMS- group.
Conclusion:
1Hz rTMS combined with anode tDCS stimulation protocol could be a preferable rehabilitative strategy for motor recovery in subacute stroke patients.</description><identifier>ISSN: 0269-2155</identifier><identifier>EISSN: 1477-0873</identifier><identifier>DOI: 10.1177/0269215520972940</identifier><identifier>PMID: 33222502</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Aged ; Barthel Index ; Clinical trials ; Cortex ; Cortical Excitability - physiology ; Evaluation ; Evoked Potentials, Motor - physiology ; Female ; Hospitals ; Humans ; Inpatient care ; Intervention ; Lower Extremity - physiopathology ; Male ; Middle Aged ; Motor ability ; Motor Cortex - physiopathology ; Outcome Assessment, Health Care ; Resting ; Stroke ; Stroke - complications ; Stroke - physiopathology ; Stroke Rehabilitation ; Transcranial Direct Current Stimulation ; Transcranial Magnetic Stimulation</subject><ispartof>Clinical rehabilitation, 2021-05, Vol.35 (5), p.718-727</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-a5d131cbc4cbd534adc6a8481c5a953047a38643b1f24216f60e1a5404dd05963</citedby><cites>FETCH-LOGICAL-c365t-a5d131cbc4cbd534adc6a8481c5a953047a38643b1f24216f60e1a5404dd05963</cites><orcidid>0000-0001-5473-290X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0269215520972940$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0269215520972940$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,30976,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33222502$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gong, Yan</creatorcontrib><creatorcontrib>Long, Xian-Ming</creatorcontrib><creatorcontrib>Xu, Ying</creatorcontrib><creatorcontrib>Cai, Xiu-Ying</creatorcontrib><creatorcontrib>Ye, Ming</creatorcontrib><title>Effects of repetitive transcranial magnetic stimulation combined with transcranial direct current stimulation on motor function and cortex excitability in subacute stroke patients: A randomized controlled trial</title><title>Clinical rehabilitation</title><addtitle>Clin Rehabil</addtitle><description>Objective:
To explore effects of repetitive transcranial magnetic stimulation (rTMS) combined with transcranial direct current stimulation (tDCS) on motor function and cortex excitability in subacute stroke patients.
Design:
Randomized controlled trial.
Setting:
Inpatient hospitals.
Subjects:
Sixty-five participants were randomly assigned to four groups: sham, 1Hz rTMS, cathodic tDCS combined with 1Hz rTMS (tDCS-/rTMS-) and anodic tDCS combined with 1Hz rTMS (tDCS+/rTMS-).
Interventions:
Four interventions were used, including sham, 1Hz rTMS, and cathodal or anodal tDCS, followed by 1Hz rTMS over contralesional motor cortex, which continued for four weeks.
Main measures:
Outcome measures were motor function and cortical excitability, evaluated by Fugl-Meyer Assessment, National Institutes of Health Stroke Scale and Barthel Index, resting Motion Threshold, Motor Evoked Potentials and Central Motor Conduction Time, assessed at baseline, four weeks and eight weeks.
Results:
At four weeks after interventions, Fugl-Meyer Assessment lower limb change score in tDCS+/rTMS- group was significantly larger than other three groups (P < 0.001). There were significant differences in bilateral Motor Evoked Potentials changes between tDCS+/rTMS- group and sham group (P < 0.05). At eight weeks, compared to other groups, National Institutes of Health Stroke Scale (P = 0.003), Barthel Index (P = 0.002), FMA lower limb score (P < 0.001), and bilateral resting Motion Threshold, Motor Evoked Potentials (P < 0.05) showed significant changes in tDCS+/rTMS- group. Furthermore, Fugl-Meyer Assessment lower limb change score was associated with increased ipsilesional Motor Evoked Potentials (r = 0.703 P < 0.001) in tDCS+/rTMS- group.
Conclusion:
1Hz rTMS combined with anode tDCS stimulation protocol could be a preferable rehabilitative strategy for motor recovery in subacute stroke patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Barthel Index</subject><subject>Clinical trials</subject><subject>Cortex</subject><subject>Cortical Excitability - physiology</subject><subject>Evaluation</subject><subject>Evoked Potentials, Motor - physiology</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inpatient care</subject><subject>Intervention</subject><subject>Lower Extremity - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motor ability</subject><subject>Motor Cortex - physiopathology</subject><subject>Outcome Assessment, Health Care</subject><subject>Resting</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - physiopathology</subject><subject>Stroke Rehabilitation</subject><subject>Transcranial Direct Current Stimulation</subject><subject>Transcranial Magnetic Stimulation</subject><issn>0269-2155</issn><issn>1477-0873</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp1kU1rFTEYhYNY7LW6dyUBN25G8z0z7kqpH1Bw066HTPJOTZ1JrklGW3-mv8j39lalBSEkIeec5w0cQl5w9obztn3LhOkF11qwvhW9Yo_Ihqu2bVjXysdks5ObnX5InpZyxRjrhOJPyKGUQgjNxIb8Op0mcLXQNNEMW6ihhu9Aa7axONyCneliLyMKjpYalnW2NaRIXVrGEMHTH6F-ue_3ISOSujVniPVeCteSasp0WqO7fbHRIytXuKZw7UK1Y5hDvaEh0rKO1q0VkJDTV6BbZCCwvKPHFEf5tISfsEtH1OcZrzXj_GfkYLJzged35xG5eH96fvKxOfv84dPJ8VnjpNG1sdpzyd3olBu9lsp6Z2ynOu607bVkqrWyM0qOfBJKcDMZBtxqxZT3TPdGHpHXe-42p28rlDosoTiYZxshrWUQykjd98YwtL56YL1Ka474u0FoLNK0XGl0sb3L5VRKhmnY5rDYfDNwNuz6Hh72jZGXd-B1XMD_DfwpGA3N3lDsJfyb-l_gby2VuEQ</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Gong, Yan</creator><creator>Long, Xian-Ming</creator><creator>Xu, Ying</creator><creator>Cai, Xiu-Ying</creator><creator>Ye, Ming</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5473-290X</orcidid></search><sort><creationdate>202105</creationdate><title>Effects of repetitive transcranial magnetic stimulation combined with transcranial direct current stimulation on motor function and cortex excitability in subacute stroke patients: A randomized controlled trial</title><author>Gong, Yan ; Long, Xian-Ming ; Xu, Ying ; Cai, Xiu-Ying ; Ye, Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-a5d131cbc4cbd534adc6a8481c5a953047a38643b1f24216f60e1a5404dd05963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Barthel Index</topic><topic>Clinical trials</topic><topic>Cortex</topic><topic>Cortical Excitability - physiology</topic><topic>Evaluation</topic><topic>Evoked Potentials, Motor - physiology</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Inpatient care</topic><topic>Intervention</topic><topic>Lower Extremity - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motor ability</topic><topic>Motor Cortex - physiopathology</topic><topic>Outcome Assessment, Health Care</topic><topic>Resting</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Stroke - physiopathology</topic><topic>Stroke Rehabilitation</topic><topic>Transcranial Direct Current Stimulation</topic><topic>Transcranial Magnetic Stimulation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gong, Yan</creatorcontrib><creatorcontrib>Long, Xian-Ming</creatorcontrib><creatorcontrib>Xu, Ying</creatorcontrib><creatorcontrib>Cai, Xiu-Ying</creatorcontrib><creatorcontrib>Ye, Ming</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gong, Yan</au><au>Long, Xian-Ming</au><au>Xu, Ying</au><au>Cai, Xiu-Ying</au><au>Ye, Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of repetitive transcranial magnetic stimulation combined with transcranial direct current stimulation on motor function and cortex excitability in subacute stroke patients: A randomized controlled trial</atitle><jtitle>Clinical rehabilitation</jtitle><addtitle>Clin Rehabil</addtitle><date>2021-05</date><risdate>2021</risdate><volume>35</volume><issue>5</issue><spage>718</spage><epage>727</epage><pages>718-727</pages><issn>0269-2155</issn><eissn>1477-0873</eissn><abstract>Objective:
To explore effects of repetitive transcranial magnetic stimulation (rTMS) combined with transcranial direct current stimulation (tDCS) on motor function and cortex excitability in subacute stroke patients.
Design:
Randomized controlled trial.
Setting:
Inpatient hospitals.
Subjects:
Sixty-five participants were randomly assigned to four groups: sham, 1Hz rTMS, cathodic tDCS combined with 1Hz rTMS (tDCS-/rTMS-) and anodic tDCS combined with 1Hz rTMS (tDCS+/rTMS-).
Interventions:
Four interventions were used, including sham, 1Hz rTMS, and cathodal or anodal tDCS, followed by 1Hz rTMS over contralesional motor cortex, which continued for four weeks.
Main measures:
Outcome measures were motor function and cortical excitability, evaluated by Fugl-Meyer Assessment, National Institutes of Health Stroke Scale and Barthel Index, resting Motion Threshold, Motor Evoked Potentials and Central Motor Conduction Time, assessed at baseline, four weeks and eight weeks.
Results:
At four weeks after interventions, Fugl-Meyer Assessment lower limb change score in tDCS+/rTMS- group was significantly larger than other three groups (P < 0.001). There were significant differences in bilateral Motor Evoked Potentials changes between tDCS+/rTMS- group and sham group (P < 0.05). At eight weeks, compared to other groups, National Institutes of Health Stroke Scale (P = 0.003), Barthel Index (P = 0.002), FMA lower limb score (P < 0.001), and bilateral resting Motion Threshold, Motor Evoked Potentials (P < 0.05) showed significant changes in tDCS+/rTMS- group. Furthermore, Fugl-Meyer Assessment lower limb change score was associated with increased ipsilesional Motor Evoked Potentials (r = 0.703 P < 0.001) in tDCS+/rTMS- group.
Conclusion:
1Hz rTMS combined with anode tDCS stimulation protocol could be a preferable rehabilitative strategy for motor recovery in subacute stroke patients.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>33222502</pmid><doi>10.1177/0269215520972940</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5473-290X</orcidid></addata></record> |
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| ispartof | Clinical rehabilitation, 2021-05, Vol.35 (5), p.718-727 |
| issn | 0269-2155 1477-0873 |
| language | eng |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; SAGE Complete |
| subjects | Adult Aged Barthel Index Clinical trials Cortex Cortical Excitability - physiology Evaluation Evoked Potentials, Motor - physiology Female Hospitals Humans Inpatient care Intervention Lower Extremity - physiopathology Male Middle Aged Motor ability Motor Cortex - physiopathology Outcome Assessment, Health Care Resting Stroke Stroke - complications Stroke - physiopathology Stroke Rehabilitation Transcranial Direct Current Stimulation Transcranial Magnetic Stimulation |
| title | Effects of repetitive transcranial magnetic stimulation combined with transcranial direct current stimulation on motor function and cortex excitability in subacute stroke patients: A randomized controlled trial |
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