Long-term effects of rTMS on motor recovery in patients after subacute stroke

Repetitive transcranial magnetic stimulation (rTMS) has been recognized as a promising intervention for treatment of stroke patients. However, most previous reports have described the short-term effects of rTMS on motor performance. We conducted a sham-controlled trial to evaluate long-term effects of high-frequency rTMS on motor recovery in subacute stroke patients. Twenty-eight patients were randomly divided into two groups, and received either real or control rTMS. Both treatments were accompanied by motor practice. A daily dose of 1000 pulses of subthreshold 10 Hz rTMS was applied over the primary motor cortex of the affected hemisphere for 10 days within one month after onset of stroke. Motor function was assessed before and after treatment, and 3 months after the stroke. Motor function improved in both groups after treatment; however, patients who received real rTMS experienced additional improvement in motor function of the affected upper limb. Over 3 months after the stroke, the time and type of intervention for the Motoricity Index of the affected upper extremity showed significant interaction. Positive long-term effects on motor recovery could be achieved after 10 daily sessions of high-frequency rTMS in conjunction with motor practice during the sub-acute period of stroke.